Preventive Intervention Against Lymphedema After Breast Cancer Surgery (LYCA)
LYCA: Preventive Intervention Against Lymphedema After Breast Cancer Surgery - a Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Lymphedema is a well known and much dreaded complication after breast cancer surgery. The aim in this study is to examine if lymphedema can be prevented with early progressive strength training focusing on the arm, and close monitoring of pre clinical lymphedema in the 1 year exercise period. The primary outcome is lymphedema, and secondary outcomes are pain, self-reported symptoms of swelling, sensory disturbance, physical and psychological functioning, fatigue, depression, anxiety and health related quality of life.
158 patients operated for breast cancer with axillary node dissection, will be invited from three hospitals in Denmark, Sealand (Rigshospitalet, Ringsted Hospital, and Herlev Hospital), while on the surgical wards. Two weeks later upon consent they are recruited, baseline tested and randomized to either exercise intervention or usual care control.
The exercise intervention consists of progressive resistance training, combined with a stretching programme, with a total duration of 60 minutes per session. The group attend supervised exercises twice a week and a once weekly home exercise programme of 45 to 60 minutes duration. After 20 weeks, exercises are converted to home exercises, and they are monitored by a weekly sms-service. At 12 months, follow-up measurements are taken for both groups. Lymphedema is defined as 3% limb volume change from the baseline measurement.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Copenhagen, Denmark, 2100
- Danish Cancer Society Research Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- invasive unilateral breast cancer
- undergone Axillary Lymph Node Dissection (ALND), planned for Radiotherapy
- Danish speaking
- consent to participate and to be randomized to either study arm.
Exclusion Criteria:
- have undergone primary breast reconstruction
- distant metastases
- physically unable to participate for any reason
- mental illness or cognitive impairment (dementia etc.)
- no past history of lymphedema diagnosis or treatment
- not previously operated with axillary lymph node dissection either side
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: exercise group
The first 20 weeks, twice-weekly 60 minute session of physical exercise supervised by the research assistant and once weekly home exercise programme is offered. The exercise intervention will consist of stretching, scar tissue mobilization and resistance exercises. For the following 32 weeks a home-training manual specifying three times weekly training is provided. At week 26 an individual booster session will be offered. In the case of lymphedema, referral to trained lymphedema physiotherapist for evaluation of appropriate intervention is made. |
progressive resistance training
|
|
No Intervention: usual care control group
Receives all standard care offered from the operating hospital and rehabilitation in the municipality.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of participants with Lymphedema measured by water displacement measurement
Time Frame: 12 months
|
Lymphedema is defined as >3% increase in inter limb volume difference compared to baseline, measured by ml.
water displaced by lowering arm into a tub of water.
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
shoulder/arm/leg strength
Time Frame: 12 months
|
change from baseline in Newtons in hand held dynometry and in 7RM tests for dynamic muscle strength.
|
12 months
|
|
patient reported pain
Time Frame: 12 months
|
Pain through the study period measured on a pain scale developed to assess pain after breast cancer surgery by Gärtner et al (JAMA.
2009;302(18):1985-1992)
|
12 months
|
|
neuropathic pain
Time Frame: 12 months
|
Measured by questionnaire assessment on neuropathic pain scale (NeuPPS).
|
12 months
|
|
Self-reported, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) questionnaire.
Time Frame: 12 months
|
change from baseline in score on the FACIT-fatigue questionnaire
|
12 months
|
|
health related quality of life questionnaire
Time Frame: 12 months
|
Change from baseline in Health-related quality of life Self-report, The European Organisation for Research and Treatment of Cancer (EORTC QLQ C30), breast cancer specific module (BR 23).
|
12 months
|
|
International Physical Activity Questionnaire (IPAQ)
Time Frame: baseline and 12 months
|
Change in physical activity from baseline on the IPAQ
|
baseline and 12 months
|
|
tissue composition by Dual Energy X-ray Apsorptiometry (DXA)
Time Frame: 12 months
|
Change from baseline in tissue composition of bone mass, lean mass and fat mass, both regional and overall, assessed by Dual Energy X-ray absorptiometry (DXA).
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Susanne Oksbjerg Dalton, MD PhD, Danish Cancer Society Research Center
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- R96-A6604-14-S22
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