Prophylactic Compression Sleeves reduces Breast Cancer-Related Lymphedema; ASCO

In women at high risk for lymphedema, prophylactic usage of compression sleeves reduced and delayed the emergence of arm swelling in the first year after breast cancer surgery when compared to the control group, says a study published in the Journal of Clinical Oncology.

Vincent S Paramanandam and team conducted this study with the objective to see if using compression sleeves as a preventative measure reduces arm swelling in women who have had axillary lymph node dissection for breast cancer surgery.

For this study a total of 307 women were randomly allocated to one of two groups: compression or control. The compression group received two compression sleeves to wear postoperatively until three months after adjuvant treatments were completed, in addition to standard postoperative care. Bioimpedance spectroscopy (BIS) thresholds and relative arm volume increase (RAVI) were used to determine arm swelling. Kaplan-Meier analyses were used to examine the incidence of arm swelling and the time spent without it. For each of the BIS and RAVI thresholds, HRs were calculated using Cox regression models. In addition, researchers looked at the time it took for the first least meaningful difference (MID) to be documented in four scales of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the breast cancer-specific (BR23) questionnaire.

The results of this study stated as follow:

1. On the basis of BIS, the HR for developing arm swelling in the compression group compared to the control group was 0.61 (95% CI, 0.43 to 0.85; P =.004) and 0.56 (95% CI, 0.33 to 0.96; P =.034).

2. On the basis of BIS (42% v 52%) and RAVI, the estimated cumulative incidence of arm swelling at one year was lower in the compression group than in the control group (14% v 25% ).

3. For any of the four scales of the EORTC QLQ-30 and BR23 questionnaires, HRs for time from baseline to the first change of the smallest meaningful difference were not statistically significant.

In conclusion, compression sleeves, when used by women at high risk of lymphedema, are a proactive strategy to long-term lymphedema prevention. To diagnose and treat swelling, this technique can be reinforced with continuing screening programmes.

Reference:

Paramanandam VS, Dylke E, Clark GM, Daptardar AA, Kulkarni AM, Nair NS, Badwe RA, Kilbreath SL. 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. 2022 Feb 2:JCO2102567. doi:10.1200/JCO.21.02567. Epub ahead of print. PMID: 35108031.