title: Acupuncture in the treatment of upper-limb lymphedema: results of a pilot study.
abstract: BACKGROUND
  Current treatments for lymphedema after breast cancer treatment are expensive and require ongoing intervention. Clinical experience and our preliminary published results suggest that acupuncture is safe and potentially useful. This study evaluates the safety and potential efficacy of acupuncture on upper-limb circumference in women with lymphedema.
  
  
  METHODS
  Women with a clinical diagnosis of breast cancer-related lymphedema (BCRL) for 0.5-5 years and with affected arm circumference ≥2 cm larger than unaffected arm received acupuncture treatment twice weekly for 4 weeks. Affected and unaffected arm circumferences were measured before and after each acupuncture treatment. Response, defined as ≥30% reduction in circumference difference between affected/unaffected arms, was assessed. Monthly follow-up calls for 6 months thereafter were made to document any complications and self-reported lymphedema status.
  
  
  RESULTS
  Among 37 enrolled patients, 33 were evaluated; 4 discontinued due to time constraints. Mean reduction in arm circumference difference was 0.90 cm (95% CI, 0.72-1.07; P < .0005). Eleven patients (33%) exhibited a reduction of ≥30% after acupuncture treatment. Seventy-six percent of patients received all treatments; 21% missed 1 treatment, and another patient missed 2 treatments. During the treatment period, 14 of the 33 patients reported minor complaints, including mild local bruising or pain/tingling. There were no serious adverse events and no infections or severe exacerbations after 255 treatment sessions and 6 months of follow-up interviews.
  
  
  CONCLUSIONS
  Acupuncture for BCRL appears safe and may reduce arm circumference. Although these results await confirmation in a randomized trial, acupuncture can be considered for women with no other options for sustained arm circumference reduction.
authors.affiliation: Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York 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: K Simon
authors.initials: KS
authors.lastname: Yeung
authors.forename: Marci I
authors.initials: MI
authors.lastname: Coleton
authors.forename: Sara
authors.initials: S
authors.lastname: Cohen
authors.forename: Yi H
authors.initials: YH
authors.lastname: Chan
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Vickers
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Sjoberg
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Hudis
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008209:Lymphedema / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D061214:Patient Safety; D010865:Pilot Projects; D012107:Research Design; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D034941:Upper Extremity