Weight Lifting Does Not Appear to Increase Risk of Lymphedema in Breast Cancer Survivors

A slowly progressive weight lifting program for breast cancer survivors did not increase their risk of lymphedema, according to a study that will appear in JAMA.

“Breast cancer survivors at risk for lymphedema alter activity, limit activity, or both from fear and uncertainty about their personal risk level, and upon guidance advising them to avoid lifting children, heavy bags or other objects with the at-risk arm,” according to background information in the article. “Such guidance is often interpreted in a manner that deconditions the arm, increasing the potential for injury, overuse, and, ironically, lymphedema onset.”

Kathryn H. Schmitz, Ph., MPH, of the University of Pennsylvania School of Medicine and Abramson Cancer Center, Philadelphia, and colleagues examined the incidence of lymphedema after a 1-year weight lifting intervention among survivors at risk for breast cancer-related lymphedema (BCRL). The randomized controlled trial included 154 women who were breast cancer survivors who had been diagnosed 1 to 5 years prior to entry in the study and had at least 2 lymph nodes removed and were without clinical signs of BCRL at study entry. Participants, ages 36 to 75 at the beginning of the study, were randomized to either the weight lifting intervention, which included a gym membership and 13 weeks of supervised instruction, with the remaining 9 months unsupervised, or to no exercise (control group). Data collection ended in August 2008. A total of 134 participants completed follow-up measures at 1 year.

Researchers found that the proportion of women who experienced new BCRL onset was 11% (8 of 72) in the weight lifting intervention group and 17% (13 of 75) in the control group.

“Among women with 5 or more lymph nodes removed, the proportion who experienced incident BCRL onset was 7% (3 of 45) in the weight lifting intervention group and 22% (11 of 49) in the control group. Clinician-defined BCRL onset occurred in 1 woman in the weight lifting intervention group and 3 women in the control group (1.5% vs. 4.4%).”

“The majority of breast cancer survivors do not have lymphedema; however, they alter the use of their arms and upper body activities out of fear of developing lymphedema. The findings from our trial should help clarify clinical advice to patients who have completed breast cancer treatment regarding the safety of resuming or beginning a weight lifting program,” the authors wrote.

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