Cassileth, B.R., Van Zee, K.J., Chan, Y., Coleton, M.I., Hudis, C.A., Cohen, S., . . . Vickers, A.J. (2011). A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society, 29(3),170–172.

To evaluate the safety and effectiveness of acupuncture in women diagnosed with chronic lymphedema

Women with chronic lymphedema after breast cancer surgery received acupuncture twice a week for four weeks using Acupoint prescription, chosen by consensus from members of the Memorial Sloan Kettering Cancer Center Integrative Medicine Service certified acupuncturists.

• The study sample (N = 9) was comprised of female patients aged 18 years or older.
• Median age of patients was 54 years.
• All patients had lymphedema (arm circumference greater than 2 cm in comparison to unaffected arm) for at least six months and no more than five years as a result of surgery or radiation therapy for breast cancer.
• Patients were excluded from the study if they had previous acupuncture treatment for lymphedema or current use of diuretics.

The study took place at the Integrative Medicine Service and Department of Epidemiology and Biostatistics at the Memorial Sloan-Kettering Cancer Center in New York.

The study has clinical applicability for late effects and survivorship.

The study used a prospective pilot design.

• Upper extremity volume was measured at two places on both the affected and unaffected extremities. The site with the greater difference between the affected and unaffected arms was used to determine the baseline measurement and assess outcome by comparing changes in the baseline measures.
• Positive response was considered to be 30% reduction in the difference in size between affected and unaffected upper extremities after four weeks of treatment.

After nine subjects were treated, four women demonstrated a 30% reduction in limb volume after four weeks of treatment, with no significant adverse events occurring. Some patients did experience minor toxicities, such as slight bruising or minor pain at acupuncture site shortly after treatment.

The pilot study suggests that acupuncture for women with arm lymphedema may be practical and was not associated with significant adverse effects. Further research in this area to establish safety and begin to evaluate effectiveness is planned.

• The sample size was small with less than 30 patients.
• Sample characteristics present a risk of bias.
• Measurements and methods were not well described.

Additional robust randomized controlled trials are needed to evaluate the use of acupuncture for the treatment of lymphedema.