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Cited by 410Lymphatic System and DiseasesCancer survivorship and careBreast Cancer Treatment Studies

Weight Lifting for Women at Risk for Breast Cancer–Related Lymphedema: A Randomized Trial

Schmitz, Kathryn H., Ahmed, Rehana L., Troxel, Andrea B., Cheville, Andrea, Lewis-Grant, Lorita, Smith, Rebecca, Bryan, Cathy J., Williams-Smith, Catherine T. +1 more·2010·JAMA
DOI 10.1001/jama.2010.1837
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Abstract

CONTEXT: Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise, preventing them from obtaining established health benefits of weight lifting. OBJECTIVE: To evaluate lymphedema onset after a 1-year weight lifting intervention vs no exercise (control) among survivors at risk for breast cancer-related lymphedema (BCRL). DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled equivalence trial (Physical Activity and Lymphedema trial) in the Philadelphia metropolitan area of 154 breast cancer survivors 1 to 5 years postunilateral breast cancer, with at least 2 lymph nodes removed and without clinical signs of BCRL at study entry. Participants were recruited between October 1, 2005, and February 2007, with data collection ending in August 2008. INTERVENTION: Weight lifting intervention included a gym membership and 13 weeks of supervised instruction, with the remaining 9 months unsupervised, vs no exercise. MAIN OUTCOME MEASURES: Incident BCRL determined by increased arm swelling during 12 months (≥5% increase in interlimb difference). Clinician-defined BCRL onset was also evaluated. Equivalence margin was defined as doubling of lymphedema incidence. RESULTS: A total of 134 participants completed follow-up measures at 1 year. The proportion of women who experienced incident BCRL onset was 11% (8 of 72) in the weight lifting intervention group and 17% (13 of 75) in the control group (cumulative incidence difference [CID], -6.0%; 95% confidence interval [CI], -17.2% to 5.2%; P for equivalence = .04). Among women with 5 or more lymph nodes removed, the proportion who experienced incident BCRL onset was 7% (3 of 45) in the weight lifting intervention group and 22% (11 of 49) in the control group (CID, -15.0%; 95% CI, -18.6% to -11.4%; P for equivalence = .003). Clinician-defined BCRL onset occurred in 1 woman in the weight lifting intervention group and 3 women in the control group (1.5% vs 4.4%, P for equivalence = .12). CONCLUSION: In breast cancer survivors at risk for lymphedema, a program of slowly progressive weight lifting compared with no exercise did not result in increased incidence of lymphedema. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00194363.

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  • A supervised progressive resistance training program focused on large muscle groups, performed 2-3 times per week with a "start low, progress slow" principle, is safe for upper extremity breast cancer-related lymphedema.

    “For resistance training, a general progressive program focused on large muscle groups performed 2–3 times per week, with the principle of “start low, progress slow” is safe when supervised by a fitness professional(38–42).”

    From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [39]

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Authors
Schmitz, K. H., Ahmed, R. L., Troxel, A. B., Cheville, A., Lewis-Grant, L., Smith, R., Bryan, C. J., Williams-Smith, C. T., & Chittams, J.
Affiliations
  • Abramson Cancer Center (US)
  • University of Minnesota (US)
  • University of Pennsylvania (US)
  • Mayo Clinic (US)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2010-12-22
Volume
304
Issue
24
Pages
2699
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2010.1837
OpenAlex
W2026121968
Cited by
410
References
35
Citations by year
2026: 14 · 2025: 19 · 2024: 20 · 2023: 12 · 2022: 19 · 2021: 25 · 2020: 29 · 2019: 19 · 2018: 32 · 2017: 32 · 2016: 25 · 2015: 31 · 2014: 27 · 2013: 38 · 2012: 36
FWCI
16.58
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Cancer Institute (R01CA106851)
  • National Center for Research Resources (RR 024134, UL1RR024134)
Topics
  • Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Keywords
breast cancer-related lymphedema, weightlifting, breast cancer survivors, exercise intervention, lymph node dissection, arm swelling, arm exercise, lymphedema prevention, gym membership, equivalence trials, lymphedema severity, lymphedema recurrence
MeSH terms
Aged, Breast Neoplasms, Female, Humans, Lymph Node Excision, Lymphedema, Middle Aged, Risk, Weight Lifting, Treatment Outcome, Survivors

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