Early Detection and Intervention for Mild and Moderate Lymphedema in Patients Treated for Breast Cancer
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ClinicalTrials.gov Identifier: NCT00959985 |
Recruitment Status
:
Terminated
(low accrual)
First Posted
: August 17, 2009
Results First Posted
: April 27, 2017
Last Update Posted
: May 30, 2017
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Lymphedema Breast Cancer | Device: Compression Sleeve Device: Short-Stretch Compression Bandage | Not Applicable |
- Because no one knows which of the study options is best, participant's will be randomized into one of the study groups. Participants with mild lymphedema will be randomized into either Group 1A or Group 1B. Participants with moderate lymphedema will be randomized into either Group 2A or Group 2B.
- All study participants will meet with a lymphedema physical therapist to review daily shoulder range of motion exercises to help minimize their arm swelling. They will be asked to record their range of motion exercises and activities in a study treatment journal. Participants will bring their journal to each study visit (every 4 weeks).
- Group 1A will only be required to meet with the lymphedema physical therapist as described above.
- Group 1B and Group 2A will be fitted with a compression sleeve at their first lymphedema physical therapy visit. They will wear the sleeve for a minimum of 12 hours per day.
- Group 2B will also be fitted with a compression sleeve at their first lymphedema physical therapy visit and will wear the sleeve for a minimum of 12 hours per day. They will also be instructed to wear a short-stretch compression bandage that goes from the top of the hand to the armpit. They will be asked to wear this compression bandage during the night. The overnight compression bandage should be worn for at least 5 nights out of the week.
- Participants will come to the clinic every 4 weeks. The following tests and procedures will be performed: height and weight measurements; review of any side effects; arm volume measurements for both arms; questionnaire.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 23 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Early Detection and Intervention for Mild and Moderate Lymphedema in Patients Treated for Breast Cancer: A Randomized Trial |
Study Start Date : | August 2009 |
Actual Primary Completion Date : | August 2014 |
Actual Study Completion Date : | August 2014 |
Arm | Intervention/treatment |
---|---|
No Intervention: Group 1A
Mild Lymphedema: Only required to meet with the lymphedema physical therapist
|
|
Active Comparator: Group 1B
Mild Lymphedema: Fitted for compression sleeve
|
Device: Compression Sleeve
Worn for a minimum of 12 hours per day
|
Active Comparator: Group 2A
Moderate lymphedema: Fitted with a compression sleeve
|
Device: Compression Sleeve
Worn for a minimum of 12 hours per day
|
Active Comparator: Group 2B
Moderate Lymphedema: Fitted with compression sleeve and instructed to wear a short-stretch compression bandage
|
Device: Compression Sleeve
Worn for a minimum of 12 hours per day
Device: Short-Stretch Compression Bandage
Worn overnight at least 5 nights of the week
|
- To Identify the Number of Patients Who Experienced Reduction in Edema With Compression Garment Usage for Low Volume Lymphedema Associated With Breast Cancer Treatment [ Time Frame: 5 years ]Participants who are randomized to receive compression treatment will have their arm volume measured at regular intervals throughout the study period. Participants' arm volume, as measured by the validated Relative Volume Change (RVC) equation, at the end of the intervention period will be assessed to determine the efficacy of the compression garment intervention and whether or not it was successful in reducing the participants' arm edema to RVC<10%.Data was collected in study participants enrolled in Group 1A and Group 1B only (15 patients total), and the percentage of participants who experienced reduction in edema is reported below.
- To Identify the Number of Patients Who Experienced Reduction in Edema With Compression Garments +/- Night Compression Bandaging for Moderate Volume Lymphedema Due to Breast Cancer Treatment [ Time Frame: 5 years ]Participants who are randomized to receive compression treatment with/without night bandaging will have their arm volume measured at regular intervals throughout the study period. Participants' arm volume, as measured by the validated Relative Volume Change (RVC) equation, at the end of the intervention period will be assessed to determine the efficacy of the compression garment intervention and whether or not it was successful in reducing the participants' arm edema to RVC<10%. Data was collected in participants enrolled in Group 2A and 2B only (8 participants total), and the percentage of participants who experienced reduction in edema is reported below.
- To Assess Survey Response Scores Regarding Symptoms Associated With Varying Degrees of Lymphedema [ Time Frame: 5 years ]Symptoms were assessed through the Lymphedema Evaluation Following Treatment of Breast Cancer (LEFT-BC) survey. The responses were scored on a scale from 0-51, where higher score was associated with presence of more symptoms (0=no symptoms, 51 = most symptoms)
- To Assess Survey Response Scores Regarding Fear Avoidance Behavior Associated With Varying Degrees of Lymphedema [ Time Frame: 5 years ]Fear avoidance behavior was assessed through the Lymphedema Evaluation Following Treatment of Breast Cancer (LEFT-BC) survey. Participant responses were scored on a scale from 7-28, where higher score was associated with higher level of fear of using arm (7= least fear level; 28= most fear level)
- To Assess Survey Response Scores Regarding Quality of Life as it Associated With Varying Degrees of Lymphedema [ Time Frame: 5 years ]Quality of life was assessed through the Lymphedema Evaluation Following Treatment of Breast Cancer (LEFT-BC) survey. Participant responses were scored on a scale from 0-141, where higher score was associated with higher post-operative quality of life (0= worst; 141= best)
- To Assess Survey Response Scores Regarding Upper Extremity Function as it Associated With Varying Degrees of Lymphedema [ Time Frame: 5 years ]Upper extremity functions were assessed through the Lymphedema Evaluation Following Treatment of Breast Cancer (LEFT-BC) survey. Participant responses were scored on a scale from 19-95, where higher score was associated with more difficulty utilizing arm for daily activities (19 = least difficulty; 95 = most difficulty)
- To Identify the Number of Patients With Risk Factors Associated With the Onset of Lymphedema That Are Both Related and Unrelated to Treatment for Breast Cancer [ Time Frame: 5 years ]Surgical and radiation therapy risk factors for lymphedema (surgery to lymph nodes, radiation to lymph nodes), as well as risk factors unrelated to breast cancer treatment such as high BMI were collected upon medical record review
- To Evaluate the Number of Patients With Low-level Arm Swelling in Order to Understand the Natural History of Lymphedema After Treatment for Breast Cancer [ Time Frame: 5 years ]We recorded the number of participants who had low-level arm swelling, as defined by the Relative Volume Change (RVC) equation of >5%-<10%, at the time of their post-operative follow up to determine if women who had low-level arm swelling were more likely to develop lymphedema

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Ages Eligible for Study: | 18 Years and older (Adult, Senior) |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Participants must have histologically or cytologically confirmed invasive or in-situ carcinoma of the breast
- Participants must have undergone sentinel lymph node mapping or axillary dissection
- Participants must have had a pre-operative Perometer measurement, and consecutive measurement at 4-6 month intervals prior to the onset of low volume edema (>5% from baseline)
- Age > 18 years
- Life expectancy of greater than 1 year
- Participants must have a Perometer measurement of 5% or greater volume difference (RVC) to qualify for randomization
- Ability to understand and willingness to sign a written informed consent document
- Willingness to comply with required follow up Perometer measurements and clinical visits
Exclusion Criteria:
- Known metastatic disease or other locally advanced disease in the thoracic or cervical regions
- Any patient who will not be returning routinely for follow-up
- Known brain metastases will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events
- History of primary lymphedema
- History of prior surgery or radiation to the head, neck, upper limb, or trunk
- Evidence that axillary lymph node malignancy is causing lymphedema due to recurrence as per physician discretion
- Any patient who has bilateral lymph node mapping or dissection
- Any patient with a current case of cellulitis
- Patients with a history of a different malignancy are ineligible except for the following circumstances. Individuals with a history of other malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be at low risk for recurrence of that malignancy. Individuals with the following cancer are eligible if diagnosed and treated within the past 5 years: cervical cancer in situ, and basal cell or squamous cell carcinoma of the skin

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00959985
United States, Massachusetts | |
Massachusetts General Hospital | |
Boston, Massachusetts, United States, 02114 |
Principal Investigator: | Alphonse G. Taghian, MD, PhD | Massachusetts General Hospital |
Responsible Party: | Alphonse Taghian, MD, PhD, Chief of Breast Service, Radiation Oncology, Massachusetts General Hospital |
ClinicalTrials.gov Identifier: | NCT00959985 History of Changes |
Other Study ID Numbers: |
08-308 R01CA139118 ( U.S. NIH Grant/Contract ) |
First Posted: | August 17, 2009 Key Record Dates |
Results First Posted: | April 27, 2017 |
Last Update Posted: | May 30, 2017 |
Last Verified: | April 2017 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Undecided |
Keywords provided by Alphonse Taghian, MD, PhD, Massachusetts General Hospital:
compression sleeve compression bandage |
Additional relevant MeSH terms:
Breast Neoplasms Lymphedema Neoplasms by Site Neoplasms |
Breast Diseases Skin Diseases Lymphatic Diseases |