{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:13:45Z","timestamp":1790007225674,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["RP\u2010PG\u20100608\u201010168"],"award-info":[{"award-number":["RP\u2010PG\u20100608\u201010168"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Around 25% of women undergoing Axillary Clearance (ANC) develop lymphedema (LE). Intervention with a compression garment is recommended to prevent LE but no randomised evidence exists to support this strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomised trial tested standard management versus application of graduated compression garments (20\u201024\u2009mmHg) to affected arm, for 1\u00a0year. Women with node positive breast cancer (<jats:italic>n<\/jats:italic>\u00a0=\u20091300) undergoing ANC consented to arm volume measurements and those developing a 4\u20139% relative arm volume increase (RAVI) (subclinical LE) within 9\u00a0months post\u2010surgery were randomised. Primary outcome was proportion of patients developing LE (RAVI\u2009&gt;\u200910%) by 24\u2010months in each group. Secondary endpoints included Quality of life in each group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total 143 patients were randomised (74 no sleeve: 69 compression sleeve) between October 2010 and November 2015. The lymphoedema rate at 24\u2009months in the \u2018no sleeve\u2019 group was at 41%, similar to the \u2018sleeve\u2019 group (30%: <jats:italic>p<\/jats:italic>\u00a0=\u20090.32). Thirtytwo patients randomised to the \u2018no sleeve\u2019 group had a sleeve applied within 24\u2009months. Body Mass Index (BMI) at randomisation predicted LE at any time point HR 1.04 (CI 1.01\u20131.08; <jats:italic>p<\/jats:italic>\u00a0=\u20090.01). Patients with obesity (BMI\u2009&gt;\u200930) had higher rates of LE in both groups (46%) compared to those with BMI\u2009&lt;\u200930 (24%). No difference between patients was found in either group in changes in QoL. Compression sleeves applied after development of LE improved QoL scores (FACT\u2010B <jats:italic>p<\/jats:italic>\u00a0=\u20090.007:TOI <jats:italic>p<\/jats:italic>\u00a0=\u20090.042).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early intervention with External Compression garments does not prevent clinical LE, particularly in women with a high BMI\u2009&gt;\u200930. The use of prophylactic garments in subclinical LE (RAVI\u2009&lt;\u20099%) is unwarranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5378","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T09:10:26Z","timestamp":1670836226000},"page":"5506-5516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Prevention of lymphoedema after axillary clearance by external compression sleeves <scp>PLACE<\/scp> randomised trial results. Effects of high <scp>BMI<\/scp>"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6007-056X","authenticated-orcid":false,"given":"Nigel J.","family":"Bundred","sequence":"first","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"},{"name":"University of Manchester, Manchester Academic Health Sciences Centre (MAHSC) Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Barrett","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"},{"name":"University of Manchester, Manchester Academic Health Sciences Centre (MAHSC) Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chriss","family":"Todd","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"},{"name":"University of Manchester, Manchester Academic Health Sciences Centre (MAHSC) Manchester  Manchester UK"},{"name":"School of Health Sciences, Faculty of Biology, Medicine and Health The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Morris","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"},{"name":"University of Manchester, Manchester Academic Health Sciences Centre (MAHSC) Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Watterson","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust  Manchester UK"},{"name":"University of Manchester, Manchester Academic Health Sciences Centre (MAHSC) Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnie","family":"Purushotham","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Riches","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Foundation Trust  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Evans","sequence":"additional","affiliation":[{"name":"Poole NHS Foundation Trust  Poole UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Skene","sequence":"additional","affiliation":[{"name":"Royal Bournemouth NHS Foundation Trust  Bournemouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaughan","family":"Keeley","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Foundation Trust  Derby UK"},{"name":"University of Nottingham Medical School  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Investigators of BEA\/PLACE studies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003141.pub2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djj158"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2011.0007"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-005-9025-7"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1023330206021"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70076-7"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-020-0844-4"},{"key":"e_1_2_12_9_1","unstructured":"International Framework Document for Lymphoedema Best Practice for Management of Lymphoedema 2006: Medical Education Partnership 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