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Acupuncture for breast cancer-related lymphedema: a randomized controlled trial

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Abstract

Purpose

Approximately 20% of breast cancer survivors develop breast cancer-related lymphedema (BCRL), and current therapies are limited. We compared acupuncture (AC) to usual care wait-list control (WL) for treatment of persistent BCRL.

Methods

Women with moderate BCRL lasting greater than six months were randomized to AC or WL. AC included twice weekly manual acupuncture over six weeks. We evaluated the difference in circumference and bioimpedance between affected and unaffected arms. Responders were defined as having a decrease in arm circumference difference greater than 30% from baseline. We used analysis of covariance for circumference and bioimpedance measurements and Fisher’s exact to determine the proportion of responders.

Results

Among 82 patients, 73 (89%) were evaluable for the primary endpoint (36 in AC, 37 in WL). 79 (96%) patients received lymphedema treatment before enrolling in our study; 67 (82%) underwent ongoing treatment during the trial. We found no significant difference between groups for arm circumference difference (0.38 cm greater reduction in AC vs. WL, 95% CI − 0.12 to 0.89, p = 0.14) or bioimpedance difference (1.06 greater reduction in AC vs. WL, 95% CI − 5.72 to 7.85, p = 0.8). There was also no difference in the proportion of responders: 17% AC versus 11% WL (6% difference, 95% CI – 10 to 22%, p = 0.5). No severe adverse events were reported.

Conclusions

Our acupuncture protocol appeared to be safe and well tolerated. However, it did not significantly reduce BCRL in pretreated patients receiving concurrent lymphedema treatment. This regimen does not improve upon conventional lymphedema treatment for breast cancer survivors with persistent BCRL.

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Acknowledgements

This study was funded in part by a National Cancer Institute R21CA173263 (Bao) and R01CA158243 (Mao), a Memorial Sloan Kettering Cancer Center P30 Grant (P30-CA008748), and the Byrne Fund and the Translational Research and Integrative Medicine Fund, both at Memorial Sloan Kettering Cancer Center. The funding sources had no involvement in the study design; collection, analysis and interpretation of data; writing of the report; or decision to submit the article for publication.

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Authors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA

    Ting Bao, Wanqing Iris Zhi, Emily A. Vertosick, Qing Susan Li, Janice DeRito, Andrew Vickers, Barrie R. Cassileth, Jun J. Mao & Kimberly J. Van Zee

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  1. Ting Bao
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  2. Wanqing Iris Zhi
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  3. Emily A. Vertosick
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  4. Qing Susan Li
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  5. Janice DeRito
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  6. Andrew Vickers
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  7. Barrie R. Cassileth
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  8. Jun J. Mao
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  9. Kimberly J. Van Zee
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Correspondence to Ting Bao.

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Bao, T., Iris Zhi, W., Vertosick, E.A. et al. Acupuncture for breast cancer-related lymphedema: a randomized controlled trial. Breast Cancer Res Treat 170, 77–87 (2018). https://doi.org/10.1007/s10549-018-4743-9

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  • DOI: https://doi.org/10.1007/s10549-018-4743-9

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