In an Indian single-center study reported in the Journal of Clinical Oncology, Paramanandam et al found that the prophylactic use of compression sleeves reduced the risk of arm swelling in women with breast cancer undergoing axillary lymph node dissection.
Study Details
In the study, 301 evaluable women at Tata Memorial Hospital were randomly assigned between February and December 2018 to use compression sleeves (n = 152) or a control group (n = 149) in addition to usual postoperative care. The compression group received two compression sleeves to wear postoperatively until 3 months after the completion of adjuvant treatments.
Arm swelling was assessed using bioimpedance spectroscopy thresholds and relative arm volume increase. The primary endpoint was the development of arm swelling according to bioimpedance spectroscopy in the first year after surgery.
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Key Findings
According to bioimpedance spectroscopy, arm swelling occurred in 58 of 152 patients in the compression group vs 80 of 149 in the control group (hazard ratio [HR] = 0.61, 95% confidence interval [CI] = 0.43–0.85, P = .004), with an estimated cumulative incidence at 1 year of 42% (95% CI = 34%–51%) vs 52% (95% CI = 44%–61%). On multivariate analysis, older age (HR = 1.04, P < .001) and receipt of neoadjuvant chemotherapy (HR = 1.79, P = .004) were significantly associated with time to first arm swelling event; compression treatment remained a significant factor after adjustment for these variables (HR = 0.60, 95% CI = 0.43–0.85, P = .004).
According to relative arm volume increase, arm swelling occurred in 22 vs 37 patients (HR = 0.56, 95% CI = 0.33–0.96, P = .034), with an estimated cumulative incidence at 1 year of 14% (95% CI = 9%–22%) vs 25% (95% CI = 19%–33%). On multivariate analysis, older age (HR = 1.03, P = .036) and receipt of neoadjuvant chemotherapy (HR = 1.89, P = .046) were significantly associated with time to first arm swelling event; compression treatment remained a significant factor after adjustment for these variables (HR = 0.57, 95% CI = 0.34–0.97, P = .038).
Hazard ratios for time to first change of minimally important difference were not significant for the general health and physical functioning scales on the EORTC Quality of Life Questionnaire (QLQ)-C30, or the breast symptoms and arm symptoms scales on the EORTC QLQ breast cancer–specific (BR23) questionnaire.
The investigators concluded, “Prophylactic use of compression sleeves compared with the control group reduced and delayed the occurrence of arm swelling in women at high risk for lymphedema in the first year after surgery for breast cancer.”
Sharon L. Kilbreath, BScPT, MCISci, PhD, of the Faculty of Medicine and Health, The University of Sydney, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
