title: A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema.
abstract: BACKGROUND
  Lymphoedema is a distressing problem affecting many women after breast cancer surgery. There is no cure and existing treatments are marginally beneficial, rarely reducing arm swelling in any meaningful way. Needling and even lifting of objects using the affected arm has been prohibited, but our clinical experience and that of others suggested that acupuncture was safe and that it might be a useful treatment for lymphoedema.
  
  
  OBJECTIVE
  We sought to conduct a pilot study of the safety and effectiveness of acupuncture in women diagnosed with chronic lymphoedema for at least 6 months and less than 5 years.
  
  
  METHODS
  Women with chronic lymphoedema (affected arm with >2 cm circumference than unaffected arm) after breast cancer surgery received acupuncture twice a week for 4 weeks. Response was defined as at least a 30% reduction in the difference in size between the affected and unaffected arms. Monthly follow-up calls for 6 months following treatment were made to obtain information about side effects.
  
  
  RESULTS
  Study goals were met after nine subjects were treated: four women showed at least a 30% reduction in the extent of lymphoedema at 4 weeks when compared with their respective baseline values. No serious adverse events occurred during or after 73 treatment sessions. Limitations This pilot study requires a larger, randomised follow-up investigation plus enquiries into possible mechanisms. Both are in development by our group.
  
  
  CONCLUSIONS
  Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery.
authors.affiliation: Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New York, NY 10021, USA. Cassileth@mskcc.org
authors.forename: Barrie R
authors.initials: BR
authors.lastname: Cassileth
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Van Zee
authors.forename: Yi
authors.initials: Y
authors.lastname: Chan
authors.forename: Marci I
authors.initials: MI
authors.lastname: Coleton
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Hudis
authors.forename: Sara
authors.initials: S
authors.lastname: Cohen
authors.forename: James
authors.initials: J
authors.lastname: Lozada
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Vickers
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008209:Lymphedema / Q000628:therapy*; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome