ABSTRACT
Background: Weight loss can improve breast cancer related lymphoedema [BCRL] (Shaw et al. [1]), but is not routinely advised in clinical practice which just involves standard arm mobility exercises. We are determining whether supervised or home based diet and exercise weight loss programmes are effective for reducing weight and lymphoedema in a feasibility study This abstract presents preliminary data on compliance to the weight loss interventions. Aims: To evaluate change in weight, body fat, waist circumference, dietary intake and physical activity in breast cancer survivors’ with lymphoedema who were randomised to either a 12 week supervised or home based diet and exercise weight loss programme or two comparison groups.Methods: Ethical approval was granted by North West 10 Research Ethics Committee – Greater Manchester North 11/H1011/2 .Fifty seven overweight breast cancer survivors’ with lymphoedema were randomly assigned: Supervised group, diet and exercise weight loss advice delivered during weekly sessions at the research facility (n= 12); Home- based group, diet and exercise weight loss advice via fortnightly phone calls and tailored mailings (n=16); Comparison group 1, arm mobility and standard written weight loss advice group (n=12); Comparison group 2, arm mobility advice only group who did not receive any weight loss advice (n= 17). Data Analysis: Weight and body fat, measured via DXA and waist circumference were assessed at baseline and 12 weeks. Seven day diet and physical activity diaries were analysed for changes in energy intake and cardiovascular activity. Changes in variables apply last observation carried forward analysis. There were no planned statistical analyses in this feasibility study. Results: Four participants from the home- based diet + exercise group and four from comparison group 2 dropped out of the study. The supervised and home based groups had numerically greater reductions in body weight and body fat than the comparison groups. Changes in body fat and waist circumference represent real reductions in general and central adiposity, which are independent of any changes in weight and body water which may occur in patients with lymphoedema. Discussion: The successful reductions in body weight and fat with the two lifestyle interventions show it is possible to reduce adiposity in overweight women with BCRL. Conclusion: Further analysis from this pilot trial will assess changes in lymphoedema between the groups. The longer term adherence and success of the home based and supervised interventions would need to be tested in a larger randomised trial.