Abstract

Background: Patients treated for breast cancer with breast conserving surgery and radiotherapy (RT) often complain about swelling, heaviness, and pain in the treated breast. This pilot study was undertaken to examine if compression therapy was effective as an early treatment to reduce breast edema and symptoms assessed by Visual Analogue Scale (VAS).

Methods and Results: Fifty-six breast cancer-treated women with breast edema, diagnosed by the measurement of tissue water content by tissue dielectric constant (TDC) technique 3 months post-RT, were randomized to either an intervention group, wearing a sports bra of compression type, or a control group, wearing a standard bra daily for 9 months when tissue water content in breast, upper arm, and lateral thorax of the operated side, and symptoms assessed by VAS were evaluated. No differences were found between the groups at start or end of study concerning tissue water content or VAS. However, within both groups, a significant reduction in tissue water content and experience of heaviness was found.

Conclusion: Breast edema as well as experience of heaviness in the affected breast found at 3 months post-RT decreased after 9 months independent of whether a sports bra of compression type or a standard bra was used.

Main findings

• This was a randomized controlled pilot study evaluating the effect of 9-month intervention with compression treatment for breast edema following breast conserving surgery and RT to the breast.
• The intervention group. Patients were provided with sports bras of compression type with firm pressure flattening the breasts. The bras were of different designs, fitted for each woman, making sure they were comfortable. The bras were worn during daytime, but not during nights.
• The control group. Patients used ordinary bras during daytime, but were allowed to use loose-fitted sports bras.
• After intervention, no differences were found between the groups at different sites concerning the tissue dielectric constant ratio. In both groups, a significant reduction was found for tissue dielectric constant ratio related to breast.
• After intervention, no differences were found between the groups concerning VAS scoring of tightness, heaviness, and pain. Scores for feeling of heaviness decreased significantly (>0.05) within both groups.
• The present study was based on the hypothesis that breast edema had a similar origin as breast cancer-related arm lymphedema, which can be successfully treated with compression garments. Thus, a larger reduction of edema could be expected in the intervention group. However, similar results with decreasing edema in both groups rise the question if breast edema consists of edema of different origins.
• Oedema created by lymph node dissection with damage to lymphatic vessels may be impossible to distinguish from RT-induced edema.
• The authors believe that a variety of treatments for breast edema have been recommended to patients. However, the success of these treatments is most likely a result of the normal course of breast edema development with a natural and progressive decrease in associated inflammation. Though some patients may have large problems during the first months after RT, these problems, in most patients, will substantially reduce or disappear during the following months. Therefore, patients should be informed that the experienced symptoms most likely will diminish within months. When the symptoms are significant, a firm bra may diminish the feeling of, in particular, heaviness. However, this should not be mixed up with the feeling that the edema is ‘‘treated.’’