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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, May 16, 2022
In women at high risk for lymphedema in the first year after axillary lymph node dissection surgery, using compression sleeves prophylactically may result in significantly delayed and reduced arm swelling, according to the results of a randomized controlled trial published in the Journal of Clinical Oncology. When compared with a matched control group that received usual care, women with breast cancer who had undergone this surgery and, in addition to usual care, wore compression sleeves postoperatively until 3 months after completing adjuvant treatments experienced this benefit without negatively affecting their quality of life, physical functioning, or any other arm or breast symptoms. Usual care, noted Sharon L. Kilbreath, BScPT, MCISci, PhD, of the University of Sydney, Australia, and colleagues, involved one group education session and take-home materials about lymphedema; daily shoulder exercises; and arm, skin, and drain care.
The investigators used bioimpedance spectroscopy thresholds, and the hazard ratio for developing arm swelling in the compression group (n = 154) relative to the control group (n = 152) was determined to be 0.61 (P = .004). Alternately, in terms of relative arm volume increase, the hazard ratio was 0.56 (P = .034). Further, “the estimated cumulative incidence of arm swelling at 1 year was lower in the compression sleeves group than the control group on the basis of bioimpedance spectroscopy (42% vs. 52%) and relative arm volume increase (14% vs. 25%),” wrote the team.
This prophylactic approach may efficiently and effectively prevent lymphedema in high-risk women, noted Dr. Kilbreath and co-investigators. However, will a decreased incidence of arm swelling in the first year translate into continued decreased lymphedema over the next half-decade? The current cohort will be followed to determine the answer, the team stated.
Disclosure: The study authors’ disclosure information can be found at ascopubs.org.
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