Weight Lifting for Women at Risk for Breast Cancer–Related Lymphedema

Abstract

ORE THAN 2.4 MILLION breast cancer survivors live in the United States. 1 Lymphedema ranks high among their concerns because it causes swelling and discomfort, impairing arm function and quality of life 2,3 and increasing health care costs. 4 Lymphedema remains a frequent complication among survivors, despite lymphatic-sparing procedures such as sentinel lymph node biopsy. Of the 61% of patients who undergo sentinel lymph node biopsy, 5% to 7% develop breast cancer-related lymphedema. 5,6 However, one-third of patients with breast cancer require complete axillary dissection, 5 which is associated with 13% to 47% incident lymphedema. 7,8 Breast cancer survivors at risk for lymphedema alter activity, limit activity, or both from fear and uncertainty about their personal risk level, and upon guidance advising them to avoid lift-Context Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise, preventing them from obtaining established health benefits of weight lifting. Objective To evaluate lymphedema onset after a 1-year weight lifting intervention vs no exercise (control) among survivors at risk for breast cancer-related lymphedema (BCRL). Design, Setting, and Participants A randomized controlled equivalence trial (Physical Activity and Lymphedema trial) in the Philadelphia metropolitan area of 154 breast cancer survivors 1 to 5 years postunilateral breast cancer, with at least 2 lymph nodes removed and without clinical signs of BCRL at study entry. Participants were recruited between Oc

Supervised physical exercise improves VO2max, quality of life, and health in early stage breast cancer patients: a randomized controlled trial

“…As has been reported in several previous studies [34,47,48], women in the exercise group did not present significant swelling in the affected arm, further demonstrating that combined exercise interventions do not increase the risk of developing or exacerbating lymphedema [49,50]. It is hoped that this growing research evidence finally dismisses reticence to prescribe resistance training for patients with lymphoedema.…”

Developing a Home-Based Exercise Program in Breast Cancer Patients: A Focus Group Discussion

“…Historically, breast cancer patients have been advised not to lift weights for preventing breast cancer-related lymphedema; however, resistance training has been shown to reduce cancer-related fatigue and improve body density (10). Recently, results of two well-designed trials (11,12) revealed that weight training in breast cancer patients not only does not intensify lymphedema, but it can indeed reduce its incidence and intensity. Interestingly, in those trials the first 13 sessions were completely supervised, with gradual increase in workload, using free weights or machines.…”

Breast cancer: rehabilitation

“…Studies show that the practice of light weight high repetition resisted exercises neither increases the risk of lymphedema, nor alters arm volume in patients submitted to breast surgery with axillary dissection 17,18 or in patients with lymphedema 19 (B). The patients submitted to breast surgery with axillary dissection must be encouraged to keep the practice of unrestrained physical exercises, with no fear of developing lymphedema, since the sole risk factor for the appearance of lymphedema after axillary drainage os the presence of BMI > 25 kg/m 17 (B).…”

“…The patients submitted to breast surgery with axillary dissection must be encouraged to maintain the practice of unrestrained exercises, performing resisted training with less repetitions and light weight with the operated 17,18 or lymphedema-afflicted limb 19 (B). These exercises can be started on the following day after surgery or after one week, with no significant differences in later evolution 20 (B).…”