Seeking a safe way for the withdrawal of compression garments in patients with breast cancer related lymphoedema

Objective: Compare the evolution of lymphoedema in patients who stopped using garments with those who continued using garments during the maintenance phase. Methods: Patients with breast cancer related lymphoedema who had stabilised volume (changes <5%), without inflammatory complications for at least the last 12 months and without symptoms of worsening while not using garments were offered the possibility of ceasing garment to use in a progressive and monitored way. They were followed-up for 2 years and compared to patients who continued using garments. Outcomes were the change in excess volume and inflammatory complications. Analyses were performed using the t test and X2test (p<0.05). Results: Seventy-six patients were included, 16 of them in the no garment use group. Lymphoedema severity was mild (<20% excess volume) for 41 patients and moderate (20-40% excess volume) for 35 patients. Three patients had to return to garment use because of volume increase. There were 2 (12.5%) patients in the no garment use group who had inflammatory episodes whereas there were 9 (15%) patients in the control group (p=0.581). The mean change in excess volume after 2 years was 0.7% for the no garment use group, and 0.42% for the control group. These differences were not significant (p=0.646). There were no significant differences in the analysis stratifying by lymphoedema severity. Conclusions: At a follow-up of 2 years there were no significant differences in the change of excess volume between the patients who stopped using garments after a removal test with the patients who continued using garments. More research is warranted to determine which selected, stabilised lymphoedema patients could benefit from this reduction in the self-care burden.