A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema
Identifieur interne : 000879 ( Istex/Corpus ); précédent : 000878; suivant : 000880A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema
Auteurs : Barrie R. Cassileth ; Kimberly J. Van Zee ; Yi Chan ; Marci I. Coleton ; Clifford A. Hudis ; Sara Cohen ; James Lozada ; Andrew J. VickersSource :
- Acupuncture in Medicine [ 0964-5284 ] ; 2011-09.
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. Conclusion Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery.
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DOI: 10.1136/aim.2011.004069
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Van Zee</name><affiliation><mods:affiliation>Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Chan, Yi" sort="Chan, Yi" uniqKey="Chan Y" first="Yi" last="Chan">Yi Chan</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Coleton, Marci I" sort="Coleton, Marci I" uniqKey="Coleton M" first="Marci I" last="Coleton">Marci I. Coleton</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Hudis, Clifford A" sort="Hudis, Clifford A" uniqKey="Hudis C" first="Clifford A" last="Hudis">Clifford A. Hudis</name><affiliation><mods:affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Cohen, Sara" sort="Cohen, Sara" uniqKey="Cohen S" first="Sara" last="Cohen">Sara Cohen</name><affiliation><mods:affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Lozada, James" sort="Lozada, James" uniqKey="Lozada J" first="James" last="Lozada">James Lozada</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Vickers, Andrew J" sort="Vickers, Andrew J" uniqKey="Vickers A" first="Andrew J" last="Vickers">Andrew J. 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Cassileth</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Van Zee, Kimberly J" sort="Van Zee, Kimberly J" uniqKey="Van Zee K" first="Kimberly J" last="Van Zee">Kimberly J. Van Zee</name><affiliation><mods:affiliation>Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Chan, Yi" sort="Chan, Yi" uniqKey="Chan Y" first="Yi" last="Chan">Yi Chan</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Coleton, Marci I" sort="Coleton, Marci I" uniqKey="Coleton M" first="Marci I" last="Coleton">Marci I. Coleton</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Hudis, Clifford A" sort="Hudis, Clifford A" uniqKey="Hudis C" first="Clifford A" last="Hudis">Clifford A. Hudis</name><affiliation><mods:affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Cohen, Sara" sort="Cohen, Sara" uniqKey="Cohen S" first="Sara" last="Cohen">Sara Cohen</name><affiliation><mods:affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Lozada, James" sort="Lozada, James" uniqKey="Lozada J" first="James" last="Lozada">James Lozada</name><affiliation><mods:affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Vickers, Andrew J" sort="Vickers, Andrew J" uniqKey="Vickers A" first="Andrew J" last="Vickers">Andrew J. Vickers</name><affiliation><mods:affiliation>Integrative Medicine Service and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Acupuncture in Medicine</title><title level="j" type="abbrev">Acupunct Med</title><idno type="ISSN">0964-5284</idno><idno type="eISSN">1759-9873</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2011-09">2011-09</date><biblScope unit="volume">29</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="170">170</biblScope></imprint><idno type="ISSN">0964-5284</idno></series><idno type="istex">1304AC08C6DF58E9D71871AA04309A79EB1E03B7</idno><idno type="DOI">10.1136/aim.2011.004069</idno><idno type="href">acupmed-29-170.pdf</idno><idno type="ArticleID">acupmed-2011-004069</idno><idno type="PMID">21685498</idno><idno type="local">acupmed;29/3/170</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0964-5284</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="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. Conclusion Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>lymphoedema</json:string><json:string>acupuncture</json:string><json:string>breast cancer</json:string><json:string>lymphedema</json:string><json:string>node</json:string><json:string>axillary</json:string><json:string>mskcc</json:string><json:string>morbidity</json:string><json:string>memorial cancer center</json:string><json:string>oncol</json:string><json:string>breast cancer survivors</json:string><json:string>pilot study</json:string><json:string>chronic lymphoedema</json:string><json:string>breast cancer surgery</json:string><json:string>axillary lymph node dissection</json:string><json:string>responder</json:string><json:string>psychological morbidity</json:string><json:string>baseline</json:string><json:string>side effects</json:string><json:string>integrative medicine service</json:string><json:string>original paper</json:string><json:string>adverse effects</json:string><json:string>unaffected arms</json:string><json:string>study patients</json:string><json:string>clin oncol</json:string><json:string>survivor</json:string><json:string>integrative</json:string><json:string>olecranon process</json:string><json:string>further study</json:string><json:string>sentinel lymph node biopsy</json:string><json:string>time course</json:string><json:string>treatment sessions</json:string><json:string>respective baseline values</json:string><json:string>lymph</json:string></teeft></keywords><author><json:item><name>Barrie R Cassileth</name><affiliations><json:string>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>Kimberly J Van Zee</name><affiliations><json:string>Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>Yi Chan</name><affiliations><json:string>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>Marci I Coleton</name><affiliations><json:string>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>Clifford A Hudis</name><affiliations><json:string>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>Sara Cohen</name><affiliations><json:string>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>James Lozada</name><affiliations><json:string>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item><json:item><name>Andrew J Vickers</name><affiliations><json:string>Integrative Medicine Service and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Unlocked</value></json:item></subject><articleId><json:string>acupmed-2011-004069</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><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. 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Group Ltd</publisher><availability status="free"><p>Open Access</p></availability><date>2011-06-18</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema</title><author xml:id="author-1"><persName><forename type="first">Barrie R</forename><surname>Cassileth</surname></persName><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-2"><persName><forename type="first">Kimberly J</forename><surname>Van Zee</surname></persName><affiliation>Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-3"><persName><forename type="first">Yi</forename><surname>Chan</surname></persName><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-4"><persName><forename type="first">Marci I</forename><surname>Coleton</surname></persName><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-5"><persName><forename type="first">Clifford A</forename><surname>Hudis</surname></persName><affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-6"><persName><forename type="first">Sara</forename><surname>Cohen</surname></persName><affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-7"><persName><forename type="first">James</forename><surname>Lozada</surname></persName><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author><author xml:id="author-8"><persName><forename type="first">Andrew J</forename><surname>Vickers</surname></persName><affiliation>Integrative Medicine Service and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation></author></analytic><monogr><title level="j">Acupuncture in Medicine</title><title level="j" type="abbrev">Acupunct Med</title><idno type="pISSN">0964-5284</idno><idno type="eISSN">1759-9873</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2011-09"></date><biblScope unit="volume">29</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="170">170</biblScope></imprint></monogr><idno type="istex">1304AC08C6DF58E9D71871AA04309A79EB1E03B7</idno><idno type="DOI">10.1136/aim.2011.004069</idno><idno type="href">acupmed-29-170.pdf</idno><idno type="ArticleID">acupmed-2011-004069</idno><idno type="PMID">21685498</idno><idno type="local">acupmed;29/3/170</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011-06-18</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>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. Conclusion Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Unlocked</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-06-18">Created</change><change when="2011-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/1304AC08C6DF58E9D71871AA04309A79EB1E03B7/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">acupmed</journal-id><journal-id journal-id-type="nlm-ta">Acupunct Med</journal-id><journal-id journal-id-type="publisher-id">aim</journal-id><journal-title>Acupuncture in Medicine</journal-title><abbrev-journal-title abbrev-type="publisher">Acupunct Med</abbrev-journal-title><abbrev-journal-title>Acupunct Med</abbrev-journal-title><issn pub-type="ppub">0964-5284</issn><issn pub-type="epub">1759-9873</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">acupmed-2011-004069</article-id><article-id pub-id-type="doi">10.1136/aim.2011.004069</article-id><article-id pub-id-type="other">acupmed;29/3/170</article-id><article-id pub-id-type="other">acupmed;aim.2011.004069</article-id><article-id pub-id-type="pmid">21685498</article-id><article-id pub-id-type="other">170</article-id><article-id pub-id-type="other">aim.2011.004069</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Unlocked</subject></subj-group></article-categories><title-group><article-title>A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Cassileth</surname><given-names>Barrie R</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Van Zee</surname><given-names>Kimberly J</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Chan</surname><given-names>Yi</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Coleton</surname><given-names>Marci I</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Hudis</surname><given-names>Clifford A</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Cohen</surname><given-names>Sara</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Lozada</surname><given-names>James</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Vickers</surname><given-names>Andrew J</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib></contrib-group><aff id="A1"><label>1</label>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</aff><aff id="A2"><label>2</label>Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA</aff><aff id="A3"><label>3</label>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</aff><aff id="A4"><label>4</label>Integrative Medicine Service and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA</aff><author-notes><corresp><label>Correspondence to</label> Dr Barrie R Cassileth, Chief, Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New York, NY 10021, USA; <email xlink:type="simple">Cassileth@mskcc.org</email></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2011</year></pub-date><pub-date pub-type="epub-original"><day>18</day><month>6</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>18</day><month>6</month><year>2011</year></pub-date><volume>29</volume><volume-id pub-id-type="other">29</volume-id><volume-id pub-id-type="other">29</volume-id><issue>3</issue><issue-id pub-id-type="other">acupmed;29/3</issue-id><issue-id pub-id-type="other">3</issue-id><issue-id pub-id-type="other">29/3</issue-id><fpage>170</fpage><history><date date-type="accepted"><day>14</day><month>4</month><year>2011</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2011</copyright-year><license license-type="open-access"><p>This paper is freely available online under the BMJ Journals unlocked scheme, see <ext-link xlink:href="http://aim.bmj.com/info/unlocked.dtl" ext-link-type="uri">http://aim.bmj.com/info/unlocked.dtl</ext-link></p></license></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="acupmed-29-170.pdf"></self-uri><abstract><sec><title>Background</title><p>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.</p></sec><sec><title>Objective</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Limitations</title><p>This pilot study requires a larger, randomised follow-up investigation plus enquiries into possible mechanisms. Both are in development by our group.</p></sec><sec><title>Conclusion</title><p>Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema</title></titleInfo><name type="personal"><namePart type="given">Barrie R</namePart><namePart type="family">Cassileth</namePart><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kimberly J</namePart><namePart type="family">Van Zee</namePart><affiliation>Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yi</namePart><namePart type="family">Chan</namePart><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marci I</namePart><namePart type="family">Coleton</namePart><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Clifford A</namePart><namePart type="family">Hudis</namePart><affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sara</namePart><namePart type="family">Cohen</namePart><affiliation>Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">James</namePart><namePart type="family">Lozada</namePart><affiliation>Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew J</namePart><namePart type="family">Vickers</namePart><affiliation>Integrative Medicine Service and Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Unlocked</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2011-09</dateIssued><dateCreated encoding="w3cdtf">2011-06-18</dateCreated><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><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. Conclusion Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery.</abstract><relatedItem type="host"><titleInfo><title>Acupuncture in Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Acupunct Med</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0964-5284</identifier><identifier type="eISSN">1759-9873</identifier><identifier type="PublisherID">aim</identifier><identifier type="PublisherID-hwp">acupmed</identifier><identifier type="PublisherID-nlm-ta">Acupunct Med</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>29</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>170</start></extent></part></relatedItem><identifier type="istex">1304AC08C6DF58E9D71871AA04309A79EB1E03B7</identifier><identifier type="DOI">10.1136/aim.2011.004069</identifier><identifier type="href">acupmed-29-170.pdf</identifier><identifier type="ArticleID">acupmed-2011-004069</identifier><identifier type="PMID">21685498</identifier><identifier type="local">acupmed;29/3/170</identifier><accessCondition type="use and reproduction" contentType="open-access">This paper is freely available online under the BMJ Journals unlocked scheme, see http://aim.bmj.com/info/unlocked.dtl</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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