Smith, C.A., Pirotta, M., & Kilbreath, S. (2014). A feasibility study to examine the role of acupuncture to reduce symptoms of lymphoedema after breast cancer: A randomised controlled trial. Acupuncture in Medicine. Advance online publication. 

To determine the feasibility, acceptability, and safety of acupuncture to treat arm lymphedema in women following treatment for breast cancer

This was a randomized, controlled trial of acupuncture compared to usual treatment. Twenty women with stable, unilateral, intransient lymphedema that was present for at least six months prior were recruited. Ten participants were in the control group. The remaining 10 received 12 acupuncture treatments administered to body and arm points on the nonlymphedematous limb over eight weeks, twice weekly for four weeks then once weekly for four weeks. Clinical outcomes were assessed at baseline and again after eight weeks.

• N = 17  
• MEAN AGE = 57 years (control, SD = 8.4 years), 63.4 years (acupuncture, SD = 7.4 years)
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Breast cancer-related lymphedema
• OTHER KEY SAMPLE CHARACTERISTICS: Had lymphedema for at least six months

• SITE: Single-site    
• SETTING TYPE: Outpatient    
• LOCATION: Clinic in Sydney, Australia

• PHASE OF CARE: Late effects and survivorship
• APPLICATIONS: Palliative care 

Randomized, controlled trial

• Bioimpedance spectroscopy (BIS) and arm circumference measure (SFB7 instrument)
• Lymphoedema Symptom Intensity and Distress Survey–Arm and Trunk (LSIDS-AT)
• Measure Yourself Medical Outcome Profile (MYMOP)

Compliance with the treatment protocol was high; 37 women were recruited and 20 were included in the trial. Three women withdrew from the trial. Participants reported an average of two symptoms associated with treatment. Acupuncture did not worsen lymphedema in the intervention group. The change in BIS measurements ranged from a 0.01 increase to a 0.3 decrease in the control group. The intervention group’s BIS measurements saw an increase of 0.28 and a decrease or 0.43. No increases in swelling greater than 10% occurred. No changes in quality of life or other patient-reported outcome measures related to lymphedema were reported.

Acupuncture did not cause any significant changes in limb volume for women with arm lymphedema. It may stabilize lymphedema symptoms. No major safety concerns were identified.

• Small sample (< 30)
• Key sample group differences that could influence results
• Subject withdrawals ≥ 10%
• Other limitations/explanation: The control and intervention groups were chosen randomly, but the women in the acupuncture group had symptoms for a significantly longer period of time.

Acupuncture did not improve or exacerbate lymphedema in women who were breast cancer survivors. At this time, there is not enough research to promote the use of acupuncture as an effective intervention for the reduction of arm volume in this population.