Top Line: Should lymphedema compression be continued at night?
The Study: Lymphedema can be a life-long battle for over 20% of breast cancer survivors. After initial therapy, patients with lymphedema continue maintenance therapy with exercises, massage, and compression garments. These garments are often worn throughout the day and removed at night during sleep. In this 3-arm trial, 120 women with breast cancer lymphedema with >10% increase in affected arm volume compared to the unaffected arm were randomized to: usual daytime compression sleeve alone, daytime compression sleeve plus nighttime compression bandaging (CB), or daytime compression sleeve plus a nighttime compression system garment (NCSG). Daytime sleeves typically have higher compression and aren’t worn at night. Gentler compression devices or bandaging can be used for nighttime compression. The difference between the latter two is that the NCSG is supposed to be faster to put on and more convenient compared to the bandaging process, but it’s also more expensive. Nighttime compression was done 5 nights per week for 4 weeks and then at least 3 nights per week for a total of 12 weeks on trial. Over 95% of patients were compliant with nighttime compression. At 24 weeks, both forms of nighttime compression had greater reduction in excess lymphedema volume (12.5% for CB, 15.9% NCSG) than usual care (1.5%). When it came to absolute reduction in excess lymphedema volume, patients in the NCSG arm had significantly greater reduction compared to the CB arm.
TBL: Nighttime compression for breast cancer related lymphedema significantly improves the absolute and relative reduction in excess lymphedema volume. | McNeely, Cancer 2021