Abstract

Purpose: Lymphedema of the breast/chest wall after breast cancer treatment is often associated with pain and reduced quality of life. We conducted a pilot study to evaluate whether the use of a compression vest reduced symptoms of breast/chest wall edema in breast cancer patients.

Methods: This single-center study included patients (n=25) with symptomatic breast/chest wall edema with a pain score of ‡3 on the Numerical Rating Scales (range 1–10). The patients were instructed to wear a compression vest (Lymphatrex, Class II) for 6 months. Wilcoxon signed-rank tests were used to compare differences in patient-reported pain intensity/severity. Analyses included all patients with available data.

Results: In total, 17 (68%) continued to wear their vests for 6 months, whereas the other 8 withdrew prematurely. At baseline, median pain severity (4.9, interquartile range [IQR] 3.6–6.0) and pain interference (4.3, IQR 2.1–5.9) scores were significantly higher compared with pain scores after wearing the compression vest for 6 months (1.8 IQR 1.0–4.8 and 1.4 IQR 0.9–4.4, resp.). Patient-reported breast/chest wall swelling decreased from 92% (n=22) at baseline to 71% (n=12) at 6 months. The prevalence of moderate/severe patient-reported breast/chest wall pain declined from 63% (n=15) at baseline to 18% (n=3) at 6 months. Physical, emotional, and social functioning improved over time and was comparable to scores of the Dutch reference population.

Conclusion: The results of this pilot study suggest that a compression vest could be an acceptable and effective treatment option for patients with painful breast/chest wall edema. In compliant patients, swelling and pain was significantly reduced.

Main findings

• Patients with symptomatic lymphedema of the breast/chest wall after breast cancer treatment were recruited to wear a tailored compression vest (Thuasne).
• The study included women with pain of the breast/chest wall on a 10-point Numerical Rating Scale of three or higher and the presence of breast/chest wall edema at inclusion.
• Assessment of breast oedema was scheduled before the start of compression treatment (i.e., baseline) and at 1, 3, and 6 months thereafter.
• N = 24
• This study showed that a compression vest may be an acceptable treatment option in reducing breast pain and swelling in patients suffering from breast cancer treatmen related breast/chest wall edema. When compliant for 6 months, the use of a compression vest may improve patient reported pain and swelling of the breast/chest wall. Within a study period of 6 months, the largest decrease in swelling and pain was reported within the first 3 months after the start of using the compression vest. For one-third of the patients, the vest was not a well-acceptable treatment option, especially for patients experiencing (pre-existent) hot flushes.
• The small number of patients participating in this pilot study limited further analysis on patient and treatment factors associated with good response to compression treatment. Their results suggest that wearing a compression garment for the course of 6 months is not acceptable for all patients. Systemic therapy (e.g., hormonal and/or chemotherapy) might negatively impact the compliance to compression treatment (i.e., vest), most probably because of hot flushes. Also, compression treatment might be less effective in patients with more advanced tumor stages for whom extensive breast cancer treatment is required.
• In this study, they have chosen to allow patients to continue other edema reducing treatments while wearing the edema vest, to evaluate the role of the vest in an uncontrolled, routine care setting.
• The compression vest was not well tolerated by 32% of patients with breast/chest wall edema.