Prevention of breast cancer-related lymphedema by progressive resistance training – a long-term follow-up of a randomized controlled trial

Purpose: The risk of breast cancer-related lymphedema (BCRL) causes much concern in survivorship, and preventive interventions are lacking. In a 3.5-year questionnaire follow-up after a randomized controlled trial, we examined prevention of BCRL by resistance training. Methods: Patients with primary unilateral breast cancer (BC) were included at surgery, randomized to usual care control (CON) or resistance training intervention (INT) commencing 2–3 weeks after surgery. The intervention comprised 20 weeks of supervised progressive resistance training followed by 30 weeks of self-administered exercise. We assessed swelling of the arm/hand, axilla or breast/chest, pain and quality of life (QOL) at baseline, 20 weeks, 1 year and 3.5 years using validated scales in mailed questionnaires. Results: Of the 158 women in the trial, 84 (53%) answered the questionnaire. At the 3.5-year follow-up, swelling was reported by 18 (62%) and 21 (39%) in the CON and INT group, respectively, yielding lower odds for the INT group (OR 0.3, 95% CI 0.09; 0.88). Effects on pain and QOL diminished over time. Conclusions: The long-term risk for self-reported BCRL was reduced for participants in early initiated resistance training compared to usual care control, for women with BC undergoing surgery, axillary lymph node dissection and radiotherapy. Limitations include a high attrition rate and studies with more complete follow-up and objective measurements are needed to confirm these results. Implications for cancer survivors: Early progressive resistance training in early physical rehabilitation after BC is safe and may be a potential long-term prevention strategy for BCRL.