Women with breast cancer who undergo lymph node surgery more quickly recover full arm motion if they exercise with the help of a physical therapist, a Phase 3 trial shows.
The findings were revealed during the 2018 Cancer Survivorship Symposium in Orlando, Florida, in a presentation titled “Effects of a lymphedema prevention intervention on range of motion among women receiving lymph node dissection for breast cancer treatment (Alliance) CALGB 70305.”
A large number of women with breast cancer undergo lymph node dissection surgery, which can either be sentinel — removal of lymph nodes close to the tumor — or axillary — those around the breast and underarm.
When lymph nodes are removed or damaged, such as in breast cancer surgery, lymphatic fluid can build in surrounding tissues and cause swelling, called lymphedema, which may last for several months or longer, and cause an incapacitating decrease in motion.
The trial aimed to address how well education, with or without physical therapy, works in preventing lymphedema in women with stage 1, 2, or 3 breast cancer who had axillary lymph nodes removed.
For the trial (NCT00376597), 568 women were randomly assigned to either education only or education plus exercise. Both groups received information about lymphedema signs and strategies to reduce risk, but the second group also participated in arm stretching and breathing exercises together with a visit to a physical therapist.
To address the arm range of motion, which went from very little to full range, patients were asked to fill out surveys before their surgery, after surgery, and then 1.5 years after surgery.
Before surgery, fewer women in the exercise group reported full range of arm motion compared to those in the education only group (left arm: 58% vs 75%; right arm: 57% vs 76%).
But one year after surgery, more exercise group women had full range of motion in both arms, compared to the education only group (left arm: 91% vs 84%; right arm: 90% vs 83%).
At 18 months, 93 percent of women in both groups reported full range of motion in both arms.
Range of motion in the affected arm also improved more quickly in women who received exercise. After one year, 32% of women in this group reported improvement in the affected arm, compared to 6% in the education group.
Results show that including exercise in a lymphedema prevention strategy helps women to better recover full arm motion, the presentation stated.
“Most women who have had lymph node dissection get an instruction sheet on exercise after they are discharged from surgery but little else,” Electra D. Paskett, PhD, professor of cancer research at the Ohio State University and associate director for population sciences at the OSU Comprehensive Cancer Center and the study’s lead author, said in a news release.
“As a breast cancer survivor myself who experienced swelling after surgery, I thought it was important to try to determine if women were receiving adequate follow-up to deal with certain health issues including the loss of the range of motion in their arms,” she added.
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