Acupuncture or adapted physical activity for the management of lymphedema in breast cancer survivors

Lymphedema (LE) can cause psychophysical sequelae jeopardizing quality of life (QoL) in breast cancer (BC) survivors. Chronic LE and lack of effective therapies represent a major challenge for healthcare professionals. The aim of our study was to investigate the effects of an intervention featuring acupuncture or adapted physical activity (APA) in LE manage-ment. BC survivors (n=28) with chronic LE, recruited at the CeRiOn Center in Florence, were assessed before and after 8-week APA (n=16) or acupuncture (n=12) intervention. Body mass index and bioimpedance parameters were measured. Indirect upper limb volume measurement and ultrasonography were performed. Functional tests (i.e. wrist flexion/extension and hand strength) were also executed. QoL, depression/anxiety and pain intensity were evaluated by ULL27, HADS, distress thermometer and NRS questionnaires, respectively. Ultrasound meas-ures revealed a LE reduction in all women, though a statistically significant improvement was observed only in those who received acupuncture treatment. Volumetric measurements showed a trend toward an improvement in both intervention groups. Overall, bioimpedance measure-ments were unchanged. Wrist mobility, hand strength, pain perception, depression and QoL were all significantly ameliorated after the APA intervention.In conclusion, BC-related LE requires a multidisciplinary treatment approach involving both cancer care medical/psychological team and APA professionals to improve psychophysical out-comes and QoL.