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Effect of progressive resistance training on persistent pain after axillary dissection in breast cancer: a randomized controlled trial

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Abstract

Purpose

Persistent pain is a known challenge among breast cancer survivors. In secondary analyses of a randomized controlled trial, we examined the effect of progressive resistance training on persistent pain in the post-operative year in women treated for breast cancer with axillary lymph node dissection.

Methods

We randomized 158 women after BC surgery with Axillary Lymph Node Dissection (ALND) (1:1) to usual care or a 1-year, supervised and self-administered, progressive resistance training intervention initiated 3 weeks after surgery. A questionnaire at baseline, 20 weeks and 12 months assessed the intensity and frequency of pain, neuropathic pain and influence of pain on aspects of daily life. We analysed the effect using linear mixed models and multinomial logistic regression models for repeated measures.

Results

A high percentage of participants experienced baseline pain (85% and 83% in the control and intervention groups respectively) and by the 12 month assessment these numbers were more than halved. A high proportion of participants also experienced neuropathic pain (88% and 89% in control and intervention group respectively), a finding that was stable throughout the study period. The effect on intensity of pain indicators favoured the exercise group, although most estimates did not reach statistical significance, with differences being small.

Conclusion

For women who had BC surgery with ALND, our progressive resistance training intervention conferred no benefit over usual care in reducing pain. Importantly, it did not increase the risk of pain both in the short and long term rehabilitative phase.

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Availability of data and Materials

Data supporting the results reported in this paper is stored at the Danish Cancer Society Research Center according to the EU General Data Protection Regulation.

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Funding

This work was supported by The Danish Cancer Society, (Grant Number R96-A6604-14-S22) and Tryg Fonden (Grant Number ID 112305).

Author information

Authors and Affiliations

  1. Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Gunn Ammitzbøll, Christoffer Johansen & Susanne Oksbjerg Dalton

  2. Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark

    Gunn Ammitzbøll & Susanne Oksbjerg Dalton

  3. Department of Anaesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark

    Kenneth Geving Andersen

  4. Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen, Denmark

    Kenneth Geving Andersen

  5. Psychosocial Aspects in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark

    Pernille Envold Bidstrup

  6. CASTLE Late Effects Unit, Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    Christoffer Johansen

  7. Department of Breast Surgery, Copenhagen University Hospital Herlev/Rigshospitalet, Copenhagen, Denmark

    Charlotte Lanng & Niels Kroman

  8. Danish Cancer Society, Copenhagen, Denmark

    Niels Kroman

  9. Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Copenhagen, Denmark

    Bo Zerahn

  10. Section for Hyperbaric Oxygen Treatment, Department for Anaesthetics and Operations, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    Ole Hyldegaard

  11. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Ole Hyldegaard

  12. Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark

    Elisabeth Wreford Andersen

Authors
  1. Gunn Ammitzbøll
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  8. Ole Hyldegaard
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  9. Elisabeth Wreford Andersen
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  10. Susanne Oksbjerg Dalton
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Contributions

GA participated in designing and executing the experiment, and in writing the manuscript. KGA was involved in designing the measurement tools, planning the analyses and in the writing of the manuscript. PEB was involved in planning the analyses and in the writing of the manuscript. CJ, NK, BZ, OH and SOD participated in designing the experiment and in writing the manuscript. CL participated in planning and execution of the study and in writing the manuscript. EWA was involved in planning and performing the statistical analyses and in writing the manuscript.

Corresponding author

Correspondence to Gunn Ammitzbøll.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethical committee in the ethical approval (H-15002714), and all procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All participants gave informed consent to participate before any study related activities were performed.

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Ammitzbøll, G., Andersen, K.G., Bidstrup, P.E. et al. Effect of progressive resistance training on persistent pain after axillary dissection in breast cancer: a randomized controlled trial. Breast Cancer Res Treat 179, 173–183 (2020). https://doi.org/10.1007/s10549-019-05461-z

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  • DOI: https://doi.org/10.1007/s10549-019-05461-z

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