Originally published as JCO Early Release 10.1200/JCO.2005.03.6749 on May 15 2006

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Randomized Controlled Trial of Weight Training and Lymphedema in Breast Cancer Survivors

Rehana L. Ahmed, William Thomas, Douglas Yee, Kathryn H. Schmitz

From the Division of Epidemiology and Community Health; Biostatistics Division, School of Public Health; University of Minnesota Cancer Center; University of Minnesota, Minneapolis, MN; and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA

Address reprint requests to Kathryn H. Schmitz, PhD, MPH, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 423 Guardian Dr, 9th Floor, Blockley Hall, Philadelphia, PA 19104; e-mail: kschmitz{at}cceb.upenn.edu

PURPOSE: Lymphedema is a common condition that breast cancer survivors face. Despite a lack of supporting evidence from prospective observational studies, occupational and leisure time physical activity are feared to be possible risk factors for lymphedema onset or exacerbation. We examined effects of supervised upper- and lower-body weight training on the incidence and symptoms of lymphedema in 45 breast cancer survivors who participated in the Weight Training for Breast Cancer Survivors study.

METHODS: Participants were on average 52 years old, 4 to 36 months post-treatment, and had axillary dissection as part of their treatment. Thirteen women had prevalent lymphedema at baseline. The intervention was twice-a-week weight training over a period of 6 months. Lymphedema was monitored at baseline and 6 months by measuring the circumference of each arm, and by self-report of symptoms and clinical diagnosis.

RESULTS: None of the intervention-group participants experienced a change in arm circumferences 2.0 cm after a 6-month exercise intervention. Self-reported incidence of a clinical diagnosis of lymphedema or symptom changes over 6 months did not vary by intervention status (P = .40 and P = .22, respectively).

CONCLUSION: This is the largest randomized controlled trial to examine associations between exercise and lymphedema in breast cancer survivors. The results of this study support the hypotheses that a 6-month intervention of resistance exercise did not increase the risk for or exacerbate symptoms of lymphedema. These results herald the need to start reevaluating common clinical guidelines that breast cancer survivors avoid upper body resistance activity for fear of increasing risk of lymphedema.

Supported by Susan G. Komen Foundation Grant No. BCTR0100442, as well as by National Institutes of Health Grants No. M01-RR00400 (UMN General Clinical Research Center), T32 CA09607-15, P30 CA77398 (Cancer Center support), T32 GM08244-15 (R.L.A.), and T32 CA09607-15 (R.L.A.), and by the University of Minnesota Thomas Shevlin pre-doctoral fellowship (R.L.A.).

Presented in part at the Annual Meeting of the American College of Sports Medicine, San Francisco, CA, May 28-June 1, 2003, and at the 94th Annual Meeting of the American Association for Cancer Research, Washington, DC, July 11-14, 2003.

This article represents original work by the authors.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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