The aim of this randomised single blinded study was to determine whether an upper limb exercise program, commencing 4-weeks after surgery for early breast cancer, prevents upper limb symptoms, such as pain, swelling, stiffness and weakness.Methods: 156 women, aged 52.5 ± 11.7 y, who had undergone either axillary node dissection (AND; n=94) or sentinel node biopsy (SNB; n=62) for unilateral breast cancer in combination with either mastectomy (n=74) or wide local excision (n=82) within the previous 4 weeks, participated. Women were randomised to either an 8-week exercise program (n=79) or to usual care (n=77); participants were stratified for type of axillary surgery (SNB or AND) and treatment site. The exercise program comprised a home program of daily passive stretching for shoulder muscles and resistance training using Thera-Band® on alternate days for muscles about the shoulder. Women also attended a weekly exercise session. Usual care included routine follow-up with their medical specialists, a breast nurse and a post-operative visit with the physiotherapist and occupational therapist who provided instructions about exercises. The primary outcome was self-reported arm and chest symptoms derived from the EORTC breast cancer specific questionnaire (BR23) which was scored out of 100 with a low score indicative of fewer symptoms. The secondary outcomes included physical measures of shoulder range of motion, strength, and swelling. Presence of lymphoedema (LE) was determined by the inter-limb impedance ratio, using bioimpedance spectroscopy.Results: After the 8-week intervention period, there was no significant difference between groups in either the self-reported or the physical measurements (Table 1).Conclusion: A weekly, supervised, 8-week upper limb exercise program is not warranted for all women with early breast cancer treated with surgery to the axilla. Usual care in which women are seen post-operatively by a physiotherapist, occupational therapist, and breast nurse with ongoing monitoring by the specialists is sufficient for most women.Acknowledgement: Supported by NSW Cancer Council
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 811.