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Previous Volume 340:346-350 February 4, 1999 Number 5 Next

	Full Text PDF Editorial by Ganz, P. A. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Lymphedema of the arms can be a serious consequence of local and regional therapy in women with breast cancer. Coumarin has been reported to be effective for the treatment of women with lymphedema; we undertook a study in which we attempted to replicate those findings.

Methods We studied 140 women with chronic lymphedema of the ipsilateral arm after treatment for breast cancer. The women received 200 mg of oral coumarin or placebo twice daily for six months and then the other treatment for the following six months. The end points of the study consisted of the volume of the arm (calculated from measurements of hand and arm circumference) and the answers on a questionnaire completed by the patient about symptoms potentially related to lymphedema.

Results The volumes of the arms at 6 and 12 months were virtually identical, regardless of whether coumarin or placebo was given first. After six months, the average volume of the affected arm increased by 21 ml during placebo treatment and 58 ml during coumarin treatment (P=0.80). In addition, answers on the patients' questionnaires were similar in the two treatment groups. After six months, only 15 percent of the women in the coumarin group and 10 percent of those in the placebo group reported that the study medication had helped a moderate or large amount (P=0.19). Coumarin was well tolerated, except that it resulted in serologic evidence of liver toxicity in 6 percent of the women.

Conclusions Coumarin is not effective therapy for women who have lymphedema of the arm after treatment for breast cancer.

Source Information

From the Mayo Clinic and Mayo Foundation, Rochester, Minn. (C.L.L., J.A.S., T.W.R., S.K.Q., P.N.); the Illinois Oncology Research Association Community Clinical Oncology Program (CCOP), Peoria (J.W.K.); Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio (R.B.M.); Siouxland Hematology–Oncology Associates, Sioux City, Iowa (J.C.M.); Ann Arbor Regional CCOP, Ann Arbor, Mich. (P.J.S.); Meritcare Hospital CCOP, Fargo, N.D. (R.L.); Sioux Community Cancer Consortium, Sioux Falls, S.D. (L.K.T.); and CentraCare Clinic, St. Cloud, Minn. (H.W.).

Address reprint requests to Dr. Loprinzi at the Mayo Clinic, 200 First St., SW, Rochester, MN 55905, or at loprinzi.charles{at}mayo.edu.

Full Text of this Article

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• Moseley, A., Carati, C., Piller, N. (2007). A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol 18: 639-646 [Abstract] [Full Text]  
• Radina, M. E., Armer, J. M. (2004). Surviving Breast Cancer and Living with Lymphedema: Resiliency among Women in the Context of Their Families. Journal of Family Nursing 10: 485-505 [Abstract]  
• Radina, M. E., Armer, J. M. (2001). Post-Breast Cancer Lymphedema and the Family: A Qualitative Investigation of Families Coping With Chronic Illness. Journal of Family Nursing 7: 281-299 [Abstract]  
• Erickson, V. S., Pearson, M. L., Ganz, P. A., Adams, J., Kahn, K. L. (2001). Arm Edema in Breast Cancer Patients. JNCI J Natl Cancer Inst 93: 96-111 [Abstract] [Full Text]  
• Harris, S. R., Hugi, M. R., Olivotto, I. A., Levine, M. (2001). Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema. CMAJ 164: 191-199 [Abstract] [Full Text]  
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