Of the morbidities resultant to breast cancer (BrCa) treatment, lymphedema is one of the most feared and prevalent with an estimated 2-400,000 diagnosed cases in the U.S. Increased ann size resultant to lymphedema may cause decreased range of motion and function, decreased muscle strength, and alters activities of daily living. Survivors may find lymphedema more distressing than mastectomy as it is less possible hide the physical manifestation and loss of arm function. Strength training is an intriguing intervention for BrCa survivors, as there is evidence exercise improves health parameters, quality of life and symptoms of arm morbidity. However, despite a lack of prospective scientific research to indicate such exercise puts BrCa survivors at risk for lymphedema, current clinical guidelines advise against participating in vigorous upper body exercise, and in particular, lifting objects that weigh more than 5 to 15 pounds. These restrictions greatly limit activities in which survivors may participate, which then negatively impacts health, function and quality of life. Strength training allows women to gradually increase strength in a controlled setting, making it less likely that the occasional activities of daily living that require strenuous upper body work (shoveling snow, carrying children) would over-stress the lymphatic system. This proposal stems from compelling preliminary data from a 6 month randomized controlled trial of progressive twice-weekly strength training in 81 recent BrCa survivors; in the treatment group, there was no onset of lymphedema or worsening of symptoms in women who had been previously diagnosed with lymphedema.. These data, combined with other reports in the literature, support this proposal of a randomized controlled trial to evaluate the effects of twice-weekly progressive strength training on lymphedema symptoms and physiology of the lymphatic system, as well as quality of life parameters, compared to a non-exercising control goup. We will recruit 288 survivors (144 with lymphedema. 144 without lymphedema) 5-15 years post-BrCa diagnosis to participate in this randomized controlled exercise intervention consisting of 2 groups (n= 144 per group). Randomization will occur within lymphedema status. The knowledge gained from this study may impact recommendations for therapeutic regimens, participation in activities of daily living, and recommendations for exercise for health promotion in BrCa survivors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1-SRRB-Y (F1))
Program Officer
Aziz, Noreen M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Pennsylvania
Biostatistics & Other Math Sci
Schools of Medicine
United States
Zip Code
Dean, Lorraine T; Moss, Shadiya L; Ransome, Yusuf et al. (2018) ""It still affects our economic situation"": long-term economic burden of breast cancer and lymphedema. Support Care Cancer :
Dean, Lorraine T; Schmitz, Kathryn H; Frick, Kevin D et al. (2018) Consumer credit as a novel marker for economic burden and health after cancer in a diverse population of breast cancer survivors in the USA. J Cancer Surviv 12:306-315
Zhang, Xiaochen; Brown, Justin C; Paskett, Electra D et al. (2017) Changes in arm tissue composition with slowly progressive weight-lifting among women with breast cancer-related lymphedema. Breast Cancer Res Treat 164:79-88
Swen, Melody; Mann, Amandeep; Paxton, Raheem J et al. (2017) Do Cancer-Related Fatigue and Physical Activity Vary by Age for Black Women With a History of Breast Cancer? Prev Chronic Dis 14:E122
Rogers, Benjamin H; Brown, Justin C; Gater, David R et al. (2017) Association Between Maximal Bench Press Strength and Isometric Handgrip Strength Among Breast Cancer Survivors. Arch Phys Med Rehabil 98:264-269
Dean, Lorraine T; Brown, Justin; Coursey, Morgan et al. (2016) Great expectations: racial differences in outcome expectations for a weight lifting intervention among black and white breast cancer survivors with or without lymphedema. Psychooncology 25:1064-70
Brown, Justin C; Schmitz, Kathryn H (2015) Weight Lifting and Physical Function Among Survivors of Breast Cancer: A Post Hoc Analysis of a Randomized Controlled Trial. J Clin Oncol 33:2184-9
Brown, Justin C; Kumar, Anagha; Cheville, Andrea L et al. (2015) Association between lymphedema self-care adherence and lymphedema outcomes among women with breast cancer-related lymphedema. Am J Phys Med Rehabil 94:288-96
Brown, Justin C; Schmitz, Kathryn H (2015) Weight lifting and appendicular skeletal muscle mass among breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 151:385-92
Winters-Stone, Kerri M; Laudermilk, Monica; Woo, Kaitlin et al. (2014) Influence of weight training on skeletal health of breast cancer survivors with or at risk for breast cancer-related lymphedema. J Cancer Surviv 8:260-8

Showing the most recent 10 out of 22 publications