Efficacy of TEAS to Prevent Lymphedema in Breast Cancer Patients Undergoing ALND

Overview

This randomized controlled trial protocol aims to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) as a preventive treatment for breast cancer-related lymphedema (BCRL) in patients undergoing axillary lymph node dissection (ALND). The study will compare TEAS with sham stimulation in 72 patients, assessing lymphedema incidence, symptom severity, and related physiological changes over an 18-month follow-up.

Background

Breast cancer-related lymphedema is a common and debilitating complication following ALND, with incidence rates up to 58.3% and onset typically within 3 years postoperatively. Current Western preventive measures are limited and mainly focus on physical therapies and lifestyle precautions. Traditional Chinese Medicine, particularly transcutaneous electrical acupoint stimulation (TEAS), offers a non-invasive approach that may prevent BCRL by stimulating acupoints without needle insertion. This trial seeks to provide high-quality evidence on TEAS's preventive role in BCRL.

Data Highlights

The study will enroll 72 breast cancer patients scheduled for ALND, randomized 1:1 to TEAS or sham TEAS groups (36 per group). Intervention includes daily TEAS from one day before surgery to three days after (except surgery day), then twice weekly for four weeks (total 12 sessions). Primary outcomes are incidence and time to onset of lymphedema within 18 months postoperatively. Secondary outcomes include VAS scores for swelling and symptoms, limb circumference and edema staging, skin thickness ultrasound, lymphangiography, and serum inflammatory markers measured at multiple time points from baseline to 18 months. Adverse events will be recorded throughout.

Key Findings

• BCRL incidence after ALND can be as high as 58.3%, with onset peaking at 18 months post-surgery.
• TEAS is a non-invasive modality that stimulates acupoints electrically without needle insertion, potentially reducing pain and infection risk.
• The trial will assess TEAS's preventive efficacy via objective measures (limb circumference, ultrasound, lymphangiography) and subjective symptom scores over 18 months.
• TEAS treatment is administered perioperatively and post-discharge, totaling 12 sessions over 5 weeks.
• Current preventive measures for BCRL are limited; TEAS could provide a novel, easily administered adjunct therapy.

Clinical Implications

If TEAS proves effective and safe, it could be integrated as a non-invasive preventive intervention for BCRL in breast cancer patients undergoing ALND. This would expand current preventive strategies beyond physical therapies and lifestyle modifications, potentially improving patient quality of life and reducing long-term complications. The ease of administration and minimal risk profile make TEAS a practical option in clinical settings.

Conclusion

This multicenter randomized trial will provide high-quality evidence on the preventive efficacy and safety of TEAS for BCRL. Positive results could establish TEAS as a valuable adjunct in breast cancer postoperative care to reduce lymphedema incidence.

References

1. Chinese Clinical Trial Registry 2024 -- Efficacy of Transcutaneous Electrical Acupoint Stimulation for BCRL Prevention