Weight lifting does not appear to increase risk of arm swelling, discomfort for breast cancer survivors

A slowly progressive weight lifting program for breast cancer survivors did not increase their risk of lymphedema (arm swelling and discomfort), according to a study in the December 22/29 issue of JAMA. The study is being released early online to coincide with its presentation at the San Antonio Breast Cancer Symposium.

Lymphedema is a frequent complication among breast cancer survivors and ranks high among their concerns, as it may impair arm function and quality of life. “Breast cancer survivors at risk for lymphedema alter activity, limit, activity, or both from fear and uncertainty about their personal risk level, and upon guidance advising them to avoid lifting children, heavy bags, or other objects with the at-risk arm. Such guidance is often interpreted in a manner that de-conditions the arm, increasing the potential for injury, overuse, and, ironically, lymphedema onset,” according to background information in the article. The authors add that adherence to these precautions may limit physical recovery after breast cancer. Lymphedema often occurs after lymph vessels or lymph nodes in the axilla (armpit) are removed by surgery or damaged by radiation, impairing the normal drainage of lymphatic fluid.

Kathryn H. Schmitz, PhD, MPH, of the University of Pennsylvania School of Medicine and Abramson Cancer Center, Philadelphia, and colleagues examined the incidence of lymphedema after a one year weight lifting intervention among survivors at risk for breast cancer related lymphedema (BCRL). The randomised controlled trial included 154 female breast cancer survivors who had been diagnosed one to five years prior to entry in the study and had at least twio lymph nodes removed and were without clinical signs of BCRL at study entry. Participants (ages 36 to 75 at the beginning of the study) were randomised to either the weight lifting intervention, which included a gym membership and thirteen weeks of supervised instruction, with the remaining nine months unsupervised, or no exercise (control group). Data collection ended in August 2008. A total of 134 participants completed follow-up measures at one year.

The researchers found that the proportion of women who experienced new BCRL onset was 11% (eight out of 72) in the weight lifting intervention group and 17% (thirteen out of 75) in the control group. “Among women with five or more lymph nodes removed, the proportion who experienced incident BCRL onset was 7% (three out of 45) in the weight lifting intervention group and 22% (eleven otu of 49) in the control group. Clinician-defined BCRL onset occurred in one woman in the weight lifting intervention group and three women in the control group (1.5% vs 4.4%).”

“The majority of breast cancer survivors do not have lymphedema; however, they alter the use of their arms and upper body activities out of fear of developing lymphedema. The findings from our trial should help clarify clinical advice to patients who have completed breast cancer treatment regarding the safety of resuming or beginning a weight lifting program,” the authors write.

The researchers note that the primary goal of this study was to test safety of weight lifting, not superiority, and that additional research is needed before concluding that weight lifting prevents lymphedema. “However, even with the finding of no harm, our results combined with previously published results for women with breast cancer related lymphedema suggest that the many health benefits of weight lifting should now become available to all breast cancer survivors.”

(Source: JAMA: The Journal of the American Medical Association)

More Information

For more information on breast cancer, types of breast cancer and its investigations and treatments, as well as some useful videos, see Breast Cancer.

For more information on resistance or weight training, including types of resistance training, exercises, its benefits, as well as some useful videos, see Resistance Training (Weight Training; Strength Training).