Comparative study of the clinical efficacy of two different coumarin dosages in the management of arm lymphedema after treatment for breast cancer

Lymphology. 1999 Mar;32(1):3-10.


In a randomized, double-blind, parallel group study, we compared the clinical efficacy of coumarin 90 mg/day (Group A) with 135 mg/day (Group B) in 77 women (age 35-65 years) with lymphedema of the upper limb secondary to surgery and irradiation for treatment of breast cancer. During 12 months of coumarin therapy, the arm volume of lymphedema and a clinical score (degree of arm edema, heaviness, hardness, and neuralgia/dysesthesia) were determined. In both groups, the volume of arm lymphedema decreased (14.9% in Group A and 13.2% in Group B) (N.S.), the overall clinical score improved (12.9 +/- 4.3 to 5.7 +/- 3.5 in Group A and from 11.7 +/- 3.7 to 4.7 +/- 3.9 in Group B) (N.S.), and the overall efficacy of coumarin was similarly good or excellent (71.9% in Group A and 68.6% in Group B) (N.S.). Only mild to moderate side effects of drug therapy were recorded. Coumarin prevents a spontaneous trend toward an increase in arm lymphedema after treatment of breast cancer, decreases the severity of local symptoms, and overall improves the quality of life. No difference was found between the apparent benefits of coumarin at 90 mg/day compared with 135 mg/day.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Arm
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Breast Neoplasms / therapy*
  • Combined Modality Therapy / adverse effects
  • Coumarins / administration & dosage*
  • Coumarins / adverse effects
  • Coumarins / therapeutic use
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Lymphedema / drug therapy*
  • Lymphedema / etiology
  • Middle Aged
  • Treatment Outcome


  • Coumarins
  • coumarin