Effects of resistance exercise in women with or at risk for breast cancer-related lymphedema

Abstract

Breast cancer survivors (BCS) have been told in the past to avoid strenuous repetitive activities in order to decrease the risk of lymphedema development. Recent evidence suggests that exercise may be beneficial to decrease the signs/symptoms and development of lymphedema.

Purpose/methods

This study assessed the arm circumferences of 27 BCS (64 ± 7 years) at baseline and every 2 weeks thereafter during a 6-month resistance exercise training (RT) intervention. RT consisted of 2 days/week of 10 exercises including two sets of 8–12 repetitions at 52–69 % of the participants’ one-repetition maximum.

Results

A repeated measure analysis of variance revealed no significant changes in percent difference of arm circumferences at any assessment point (pre, 1.31 ± 6.21 %; post, 0.62 ± 6.55 %), nor were there any adverse lymphedema-related events reported during the study.

Conclusions

These findings imply that RT can be a safe activity for women with or at risk for breast cancer-related lymphedema.

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References

  1. 1.

    American Cancer Society (2015) Cancer facts & figures 2015. Atlanta: American Cancer Society. http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf. Accessed 28 Dec 2015

  2. 2.

    Breast cancer facts and Figs. 2013–2014. http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-042725.pdf. Accessed 20 July 2015

  3. 3.

    International Society of Lymphology (2003) The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology. Lymphology 36(2):84–91

    Google Scholar 

  4. 4.

    DiSipio T, Rye S, Newman B, Hayes S (2013) Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 14(6):500–515

    Article  PubMed  Google Scholar 

  5. 5.

    Ridner S (2005) Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema. Support Care Cancer 13(11):904–911

    Article  PubMed  Google Scholar 

  6. 6.

    Cheney CL, Mahloch J, Freeny P (1997) Computerized tomography assessment of women with weight changes associated with adjuvant treatment for breast cancer. Am J Clin Nutr 66:141–146

    CAS  PubMed  Google Scholar 

  7. 7.

    Crevenna R, Maehr B, Fialka-Moser V, Keilani M (2009) Strength of skeletal muscle and quality of life in patients suffering from “typical male” carcinomas. Support Care Cancer 17(10):1325–1328

    Article  PubMed  Google Scholar 

  8. 8.

    Freedman R, Aziz N, Albanes D, et al. (2004) Weight and body composition changes during and after adjuvant chemotherapy in women with breast cancer. J Clin Endocrinol Metab 89(5):2248–2253

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Friedlaender GE, Tross RB, Doganis AC, Kirkwood JM, Baron R (1984) Effects of chemotherapeutic agents on bone. J Bone Joint Surg Am 66(4):602–607

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Ryan AS, Pratley RE, Elahi D, Goldberg AP (1995) Resistive training increases fat-free mass and maintains RMR despite weight loss in postmenopausal women. J Appl Physiol 79(3):818–823

    CAS  PubMed  Google Scholar 

  11. 11.

    Watson S, Weeks B, Weis L, Horan S, Beck B (2015) Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporis Int 26(12):2889–2894

    CAS  Article  Google Scholar 

  12. 12.

    Zehnacker CH, Bemis-Dougherty A (2007) Effect of weighted exercises on bone mineral density in post menopausal women a systematic review. J Geriatr Phys Ther 30(2):79–88

    Article  PubMed  Google Scholar 

  13. 13.

    Harris S, Niesen-Vertommen S (2000) Challenging the myth of exercise-induced lymphedema following breast cancer: a series of case reports. J Surg Oncol 74(2):95–98

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Petrek J, Pressman P, Smith R (2000) Lymphedema: current issues in research and management. CA Cancer J Clin 50(5):292–307

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Hayes S, Janda M, Cornish B, Battistutta D, Newman B (2008) Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol 26(21):3536–3542

    Article  PubMed  Google Scholar 

  16. 16.

    Kwan M, Cohn J, Armer J, Stewart B, Cormier J (2011) Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv 5(4):320–336

    Article  PubMed  Google Scholar 

  17. 17.

    Morris C, Wonders KY (2015) Concise review on the safety of exercise on symptoms of lymphedema. World J Clin Oncol 6(4):43

    PubMed  PubMed Central  Google Scholar 

  18. 18.

    Ahmed R (2006) Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol 24(18):2765–2772

    Article  PubMed  Google Scholar 

  19. 19.

    McKenzie D (2003) Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 21(3):463–466

    Article  PubMed  Google Scholar 

  20. 20.

    Cormie P, Galvao D, Spry N, Newton R (2013) Neither heavy nor light load resistance exercise acutely exacerbates lymphedema in breast cancer survivor. Integr Cancer Ther 12(5):423–432

    Article  PubMed  Google Scholar 

  21. 21.

    Cormie P, Pumpa K, Galvão DA, et al. (2013) Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: a randomised controlled trial. J Cancer Surviv 7(3):413–424

    Article  PubMed  Google Scholar 

  22. 22.

    Simonavice E, Liu P, Ilich J, Kim J, Arjmandi B, Panton L (2014) The effects of a 6-month resistance training and dried plum consumption intervention on strength, body composition, blood markers of bone turnover, and inflammation in breast cancer survivors. Appl Physiol Nutr Metab 39(6):730–739

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Simonavice E, Liu P, Ilich J, Kim J, Arjmandi B, Panton L (2015) The effects of resistance training on physical function and quality of life in breast cancer survivors. Healthcare 3(3):695–709

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    American College of Sports Medicine, Pescatello LS (2014) ACSM’s guidelines for exercise testing and prescription. Wolters Kluwer/Lippincott Williams & Wilkins Health, Philadelphia

  25. 25.

    Hayes S, Cornish B, Newman B (2005) Comparison of methods to diagnose lymphoedema among breast cancer survivors: 6-month follow-up. Breast Cancer Res Treat 89(3):221–226

    Article  PubMed  Google Scholar 

  26. 26.

    Schmitz K (2010) Balancing lymphedema risk. Exerc Sport Sci Rev 38(1):17–24

    Article  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Lee T, Kilbreath S, Sullivan G, Refshauge K, Beith J, Harris L (2009) Factors that affect intention to avoid strenuous arm activity after breast cancer surgery. Oncol Nurs 36(4):454–462

    Google Scholar 

  28. 28.

    Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–2486

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Patterson R, Cadmus L, Emond J, Pierce J (2010) Physical activity, diet, adiposity and female breast cancer prognosis: a review of the epidemiologic literature. Maturitas 66(1):5–15

    Article  PubMed  Google Scholar 

  30. 30.

    Casley-Smith J, Boris M, Weindorf S, Lasinski B (1998) Treatment for lymphedema of the arm—the Casley-Smith method. Cancer 83(S12B):2843–2860

    CAS  Article  PubMed  Google Scholar 

  31. 31.

    Kolden G, Strauman T, Ward A, et al. (2002) A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psycho-Oncology 11(5):447–456

    Article  PubMed  Google Scholar 

  32. 32.

    Cheema B, Gaul C (2006) Full-body exercise training improves fitness and quality of life in survivors of breast cancer. J Strength Cond Res 20(1):14–21

    PubMed  Google Scholar 

  33. 33.

    Courneya K, Segal R, Mackey J, et al. (2007) Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 25(28):4396–4404

    Article  PubMed  Google Scholar 

  34. 34.

    Schmitz K, Ahmed R, Troxel A, et al. (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361(7):664–673

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Fukagawa NK, Brown M, Sinacore DR, Host HH (1995) The relationship of strength to function in the older adult. J Gerontol A Biol Sci Med Sci 50(Special Issue):55–59

    Article  Google Scholar 

  36. 36.

    Foldvari M, Clark M, Laviolette LC, et al. (2000) Association of muscle power with functional status in community-dwelling elderly women. J Gerontol A Biol Sci Med Sci 55(4):M192–M199

    CAS  Article  PubMed  Google Scholar 

  37. 37.

    Adamsen L, Quist M, Midtgaard J, et al. (2005) The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Support Care Cancer 14(2):116–127

    Article  PubMed  Google Scholar 

  38. 38.

    Bunce IH, Mirolo BR, Hennessy JM, et al. (1994) Post-mastectomy lymphoedema treatment and measurement. Med J Aust 161(2):125–128

    CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the committed participants who put forth dedicated efforts to make this study possible.

Author contributions

Emily Simonavice and Lynn B. Panton were responsible for the study origin, design, and data collection and served as the primary investigators for the study. Emily Simonavice drafted and Lynn B. Panton edited and revised the initial manuscript. Jeong-Su Kim was a co-investigator of the study and contributed to the study data collection and interpretation. All authors made integral revisions, reviewed the manuscript, and approved the final manuscript.

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Corresponding author

Correspondence to Emily Simonavice.

Ethics declarations

All BCS were required to gain medical clearance before participating in baseline assessments. Participants were asked to complete a series of written documents including an informed consent. The Institutional Review Board at Florida State University reviewed and approved this study.

Ethical approval

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.”

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Simonavice, E., Kim, J. & Panton, L. Effects of resistance exercise in women with or at risk for breast cancer-related lymphedema. Support Care Cancer 25, 9–15 (2017). https://doi.org/10.1007/s00520-016-3374-0

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Keywords

  • Breast cancer survivors
  • Lymphedema
  • Arm circumference