Preventing Early Postoperative Arm Swelling and Lymphedema Manifestation by Compression Sleeves After Axillary Lymph Node Interventions in Breast Cancer Patients: A Randomized Controlled Trial

Context. Breast cancererelated lymphedema (LE) remains one of the major long-term complications after surgery. Many reports showed the effectiveness of compression in breast cancererelated LE treatment, but randomized controlled trials evaluating compression garments for postoperative prevention are lacking. Objectives. The aim of the study was to evaluate the potential role of light arm compression sleeves for reducing the incidence of early postoperative swelling and of breast cancererelated arm LE. Methods. A total of 45 women were pre-operatively randomly assigned to a group with compression of circular-knit sleeves in compression class I (15-21 mm Hg) for daily wearing (compression group [CG]; n = 23) or to a control group without compression (no CG, n = 22). Both groups underwent a standardized physical exercise program. Arm volumes were measured before surgery and one, three, six, nine, and 12 months thereafter. Results. At one month, postoperative swelling was reduced only in CG. After 12 months, the average change of excess volumes (edema) reached -67.6 mL in the CG vs. +114.5 mL in the no CG (P < 0.001). Significantly less edema was seen in the CG after three, six, nine, and 12 months. No significant difference between groups in health-related quality of life (measured by EORTC QLQ-C30) was observed. Conclusion. Fifteen to 21 mm Hg compression sleeves in combination with physical activity may be a safe and efficient option to prevent postsurgical arm swelling and development of LE. (C) 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.