Preliminary data for a small subset of initial patients in this study were previously published in Cassileth BR, Van Zee KJ, Chan Y, et al. A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema. Acupunct Med. 2011;29:170-172.
Acupuncture in the treatment of upper-limb lymphedema
Results of a pilot study
Article first published online: 10 APR 2013
Copyright © 2013 American Cancer Society
Volume 119, Issue 13, pages 2455–2461, 01 July 2013
How to Cite
Cassileth, B. R., Van Zee, K. J., Yeung, K. S., Coleton, M. I., Cohen, S., Chan, Y. H., Vickers, A. J., Sjoberg, D. D. and Hudis, C. A. (2013), Acupuncture in the treatment of upper-limb lymphedema. Cancer, 119: 2455–2461. doi: 10.1002/cncr.28093
Trial Registration clinicaltrials.gov Identifier: NCT01003951.
Ingrid Haviland provided writing and editing assistance. Special thanks to Gria Jacobs, Clinical Research Coordinator, and our Research Study Assistants, James Lozada and Allison Hirsch.
See related editorial on pages 2362–5, this issue.
- Issue published online: 17 JUN 2013
- Article first published online: 10 APR 2013
- Manuscript Accepted: 5 NOV 2012
- Manuscript Revised: 5 OCT 2012
- Manuscript Received: 17 AUG 2012
- axillary lymphadenectomy;
- lymphedema intervention;
- breast carcinoma;
- manual lymph drainage;
- complex decongestive therapy
Current treatments for lymphedema after breast cancer treatment are expensive and require ongoing intervention. Clinical experience and our preliminary published results suggest that acupuncture is safe and potentially useful. This study evaluates the safety and potential efficacy of acupuncture on upper-limb circumference in women with lymphedema.
Women with a clinical diagnosis of breast cancer−related lymphedema (BCRL) for 0.5-5 years and with affected arm circumference ≥2 cm larger than unaffected arm received acupuncture treatment twice weekly for 4 weeks. Affected and unaffected arm circumferences were measured before and after each acupuncture treatment. Response, defined as ≥30% reduction in circumference difference between affected/unaffected arms, was assessed. Monthly follow-up calls for 6 months thereafter were made to document any complications and self-reported lymphedema status.
Among 37 enrolled patients, 33 were evaluated; 4 discontinued due to time constraints. Mean reduction in arm circumference difference was 0.90 cm (95% CI, 0.72-1.07; P < .0005). Eleven patients (33%) exhibited a reduction of ≥30% after acupuncture treatment. Seventy-six percent of patients received all treatments; 21% missed 1 treatment, and another patient missed 2 treatments. During the treatment period, 14 of the 33 patients reported minor complaints, including mild local bruising or pain/tingling. There were no serious adverse events and no infections or severe exacerbations after 255 treatment sessions and 6 months of follow-up interviews.
Acupuncture for BCRL appears safe and may reduce arm circumference. Although these results await confirmation in a randomized trial, acupuncture can be considered for women with no other options for sustained arm circumference reduction. Cancer 2013;119:2455-2461. © 2013 American Cancer Society.