Compression Sleeves May Help Prevent Lymphedema After Breast Cancer Surgery

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Compression sleeves reduced the risk of arm swelling in patients with a high risk of lymphedema after breast cancer surgery, according to research published in the Journal of Clinical Oncology.

The researchers noted that current guidelines focus on early detection of lymphedema rather than prophylaxis. With their study, the researchers sought to determine if compression sleeves could prevent arm swelling in patients who underwent axillary lymph node dissection.

The study enrolled 307 women at a single center in India. The patients were randomly assigned to the compression intervention (n=154) or to usual care (n=152) from the first postoperative day.


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In the usual care arm, patients attended a single group session during which they were educated about arm, skin, and drain care, as well as daily shoulder exercises. Patients also received a booklet reviewing the contents of the group session.

In the compression intervention arm, patients received the usual care and 2 compression sleeves. They were instructed to wear the sleeves for at least 8 hours during the day from the first postoperative day until 3 months after completing adjuvant treatment.

In both groups, arm swelling was assessed using bioimpedance spectroscopy (BIS) and relative arm volume increase (RAVI).

By BIS, the cumulative incidence of arm swelling at 1 year was significantly lower in the compression arm than in the control arm — 42% and 52%, respectively (hazard ratio [HR], 0.61; 95% CI, 0.32-0.85; P =.004).

Similarly, by RAVI, the cumulative incidence of arm swelling at 1 year was significantly lower in the compression arm than in the control arm — 14% and 25%, respectively (HR, 0.56; 95% CI, 0.33-0.96; P =.034).

In a multivariate analysis of arm swelling based on BIS, the time to the first arm swelling event was significantly associated with older age (HR, 1.04; 95% CI, 1.02-1.06; P <.001) and neoadjuvant chemotherapy (HR, 1.79; 95% CI, 1.21-2.65; P =.004). However, compression treatment remained the most significant factor after adjustment for these variables (HR, 0.60; 95% CI, 0.43-0.85; P =.004). Similar results were observed in a multivariate analysis of arm swelling by RAVI.

Patient-reported outcomes showed no significant differences in quality of life between the intervention arms.

“The use of compression sleeves for women who are at high risk of lymphedema provides a proactive approach to the long-term prevention of lymphedema,” the researchers concluded. “This approach can be supplemented with ongoing screening programs to detect and manage swelling.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Paramanandam VS, Dylke E, Clark GM, et al. Prophylactic use of compression sleeves reduces the incidence of arm swelling in women at high risk of breast cancer–related lymphedema: A randomized controlled trial. J Clin Oncol. Published online February 2, 2022. doi:10.1200/JCO.21.02567



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