Berrens AC, Vis AN, van Leeuwen PJ
… +3 more, Wit EMK, van Leeuwen FWB, van der Poel HG
Lymphat Res Biol
· 2026 Feb · PMID 41265883
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BACKGROUND: The number of lymph nodes (LNs) excised during extended pelvic LN dissections (ePLND) in prostate cancer (PCa) is related to complications including lymphoceles (up to 15%) and lymphedema (up to 14%). Approac...BACKGROUND: The number of lymph nodes (LNs) excised during extended pelvic LN dissections (ePLND) in prostate cancer (PCa) is related to complications including lymphoceles (up to 15%) and lymphedema (up to 14%). Approaches that reduce the resection of LNs related to healthy anatomies may help reduce the complication rate. The aim of this study was to unravel the complexity of the pelvic lymphatics by researching to what extent the lymphatics draining the abdominal wall overlap with the ePLND template and the lymphatic metastatic spread of primary PCa lesions. METHODS: This prospective (NCT05120973), single-center study included 10 patients who underwent robot-assisted radical prostatectomy with ePLND. To visualize the lymphatic drainage of the abdominal wall, indocyanine green was injected intradermally at four sites distributed over the lower abdomen. fluorescence imaging was performed using the robot-integrated fluorescence endoscope. Harvested LNs were assessed for fluorescence and tumor content. RESULTS: In total, 195 LNs were removed (average 20/patient); 56% of these nodes were fluorescent (average 11.5/patient). Three patients were positive pathological N stage (pN1), yielding 6 positive nodes, of which in two patients the tumor-positive nodes were also found to be fluorescent (3 nodes in total [50%]). Indicating overlapping patterns. CONCLUSION: Within the ePLND template there is a 56% overlap, on a nodal level, with the lymphatic drainage from the abdominal wall. Three fluorescent LNs also contained metastases, indicating that the lymphatic drainage of healthy tissues directly converges with the drainage of the primary PCa.
Gelvosa MN, Cheon H, Kim SA
… +4 more, Do JH, Ko EJ, Suh HSP, Jeon JY
Lymphat Res Biol
· 2026 Feb · PMID 41206058
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BACKGROUND: Lymphedema is a common but distressing sequela after cancer treatment. A cure is not yet available; thus, prevention is essential in its management. METHODS AND RESULTS: Here, we used a mouse hindlimb model t...BACKGROUND: Lymphedema is a common but distressing sequela after cancer treatment. A cure is not yet available; thus, prevention is essential in its management. METHODS AND RESULTS: Here, we used a mouse hindlimb model to demonstrate the effects of exercise performed before lymph node resection and irradiation on the development of lymphedema. BALB/c mice trained on a treadmill at moderate intensity, 30 minutes/day, 5 times/week for 4 weeks, were compared to a no-exercise group ( = 7/group). Weekly limb measurements and indocyanine green (ICG) lymphangiography were performed to assess lymphedema severity. Pre-injury exercise mice consistently showed a lower percentage excess in ankle diameter, reflecting a lesser degree of swelling. Moreover, most of them exhibited the mild "splash" pattern on ICG lymphangiography, while some reverted to the normal linear pattern on the 3rd week. Meanwhile, most of the no-exercise mice displayed the moderate "stardust" and severe "diffuse" patterns throughout the observation period. Histopathological analysis revealed a lesser increase in skin thickness and a greater density of lymphatic vessels of the exercise mice. CONCLUSION: Taken together, results showed that pre-injury exercise attenuated the development of lymphedema in our mouse hindlimb model. This provides preliminary evidence on the potential preventive role of exercise in secondary lymphedema.
Boczar D, Forte AJ, Huayllani MT
… +3 more, Kassis S, Manrique OJ, McLaughlin SA
Lymphat Res Biol
· 2026 Feb · PMID 41151102
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BACKGROUND: The incidence of lymphedema may be as high as 65% among breast cancer patients, varying according to the diagnostic method and locoregional treatment. Therefore, investigations of preventive methods are highl...BACKGROUND: The incidence of lymphedema may be as high as 65% among breast cancer patients, varying according to the diagnostic method and locoregional treatment. Therefore, investigations of preventive methods are highly welcomed. Our goal was to conduct a systematic review of the literature about the use of axillary reverse mapping to prevent lymphedema during breast cancer treatment. We hypothesized that identification of arm-draining lymph nodes may decrease the incidence of lymphedema. METHODS: On October 7, 2019, we conducted a systematic review of studies in PubMed, Cochrane Clinical Answers, and Cochrane Central Register of Controlled Trials, without time frame or language limitations, on the use of axillary reverse mapping to prevent lymphedema during breast cancer treatment. We excluded articles that investigated other uses of lymphoscintigraphy, such as lymphedema diagnosis or treatment evaluation. RESULTS: Of 104 potential articles found in the literature, 5 studies fulfilled the eligibility criteria. A total of 501 patients were included. Reverse mapping was done with radiography or single-photon emission computed tomography/computed tomography. Moreover, the examination was applied with different treatments, such as axillary lymph node dissection or radiotherapy, allowing preservation of noncompromised lymph nodes. Axillary reverse mapping also had prognostic value and was used with sentinel lymph node biopsy to identify patients at higher risk for lymphedema. Only one study compared the incidence of lymphedema between patients who received standard care or reverse mapping, showing significant benefits of its use. CONCLUSIONS: Use of axillary reverse mapping to prevent lymphedema is feasible and seems to provide valuable information for breast cancer treatment. Future studies that compare reverse mapping and standard care are still necessary.
Jonis YMJ, van der Hel SR, Misère R
… +2 more, van der Hulst RRWJ, Qiu SS
Lymphat Res Biol
· 2026 Feb · PMID 41151089
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BACKGROUND: Lymph flow measurements can assist in attaining a better understanding of the lymphatic system's function and its diseases. However, assessment of lymph flow has been challenging. Transit-time ultrasound tec...BACKGROUND: Lymph flow measurements can assist in attaining a better understanding of the lymphatic system's function and its diseases. However, assessment of lymph flow has been challenging. Transit-time ultrasound technique (TTUT) provides direct quantitative lymph flow values and has been used to successfully measure lymph flow in patients with secondary lymphedema. Currently, no measurements using TTUT in healthy subjects have been reported. The aim of this study is to measure lymph flow in healthy subjects using the TTUT. METHODS AND RESULTS: Twenty consecutive patients who had an indication for a free radial forearm flap (FRFF) reconstruction were included in the study. Patients with scars on their arms, a history of extremity lymphedema, metastatic disease, or axillary node dissection were excluded. The Transonic® Microvascular Flow Probe was used to measure lymph flow during FRFF reconstruction in accordance with the Transonic® protocol for Quantitative Patency Assessment. The subdermal superficial lymphatic collecting vessels had a mean diameter of 0.40 ± 0.10 mm (range: 0.3-0.5 mm) and a mean lymph flow velocity of 0.45 ± 0.48 mL/min (range: 0.08-1.68 mL/min). Neighboring subdermal veins measured had a mean diameter of 0.48 ± 0.11 mm (range: 0.03-0.7 mm) and a mean blood flow velocity of 0.96 ± 1.73 mL/min (range: 0.07-7.40 mL/min). CONCLUSION: The TTUT is a viable method to measure real-time lymph flow velocities in healthy subjects. Future studies with a larger sample size are required to validate the TTUT measurement accuracy and establish clinical correlations.
Arends CR, An Haack C, van der Molen L
… +2 more, van den Brekel MWM, Stuiver MM
Lymphat Res Biol
· 2025 Dec · PMID 41058561
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To determine reference values for interstitial percentage water content (PWC) in the head and neck area, in a large and heterogeneous sample of non-lymphedema participants; to determine left-right interchangeability of m...To determine reference values for interstitial percentage water content (PWC) in the head and neck area, in a large and heterogeneous sample of non-lymphedema participants; to determine left-right interchangeability of measurement locations, and to explore to what extent PWC values vary with age, sex, skin type, and body mass index (BMI) at the determined measuring locations. In this cross-sectional study, a heterogeneous group of adult non-lymphedema participants was included. PWC was measured according to an earlier developed protocol by seven trained health professionals. Limits of agreement, error correlations, and bias, as determined by Bland and Altman analysis, were used to assess the left-right interchangeability. Mixed effects models were used to explore variables that explain the variety in PWC values. Stratified descriptive reference values were calculated for relevant subgroups. A total of 412 participants were included in the study. The unstratified PWC values ranged from 38.9% to 45.5%. Sex and BMI were statistically significantly correlated with PWC values, while sex is also clinically relevant. This study resulted in sex-stratified reliable reference PWC values in the head and neck area for healthy adults. A difference of 10 percentage point between the same measurement point on the left and right side of the head or neck can be considered normal. The established reference values for PWC can be used to assist diagnosis and follow-up in patients with lymphedema in the head and neck area.
Cagliyan Turk A, Eker Buyuksireci D, Erden E
… +2 more, Erden E, Borman P
Lymphat Res Biol
· 2026 Feb · PMID 41054393
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BACKGROUND: We aimed to assess the sleep quality and the relationship between sleep and fatigue and quality of life in female lipedema patients. METHODS AND RESULTS: A total of 52 patients with lipedema (Group 1) and 40...BACKGROUND: We aimed to assess the sleep quality and the relationship between sleep and fatigue and quality of life in female lipedema patients. METHODS AND RESULTS: A total of 52 patients with lipedema (Group 1) and 40 healthy control subjects (Group 2) were enrolled. The type and stage of lipedema were recorded for Group 1. The quality of sleep was assessed by using the Pittsburgh Sleep Quality Index (PSQI). The Fatigue Severity Scale (FSS) was used for assessing fatigue. Quality of life was assessed with the World Health Organization Quality of Life. The mean age of the patient group was 45.26 ± 9.81, whereas it was 42.10 ± 6.36 years in the control group ( > 0.05). The mean body mass index was 30.23 ± 4.70 in Group 1 and 28.55 ± 4.14 in Group 2 ( > 0.05). The total PSQI score was 10 (range: 7-12.75) in Group 1 and 8 (range: 5-10) in Group 2 ( < 0.05). There was no difference between the groups in terms of FSS. In the assessment of quality of life, only the physical function domain was significantly poorer in Group 1 than in Group 2 ( < 0.05). Physical function was correlated with subjective sleep quality, sleep disorder, and daytime dysfunction; fatigue was correlated with sleep disorder, daytime dysfunction, and use of sleep medications ( < 0.05). There was a correlation between the total PSQI score and physical functioning and fatigue ( < 0.05). CONCLUSION: Female patients with lipedema have poor sleep quality and decreased quality of life. Sleep disturbance is associated with both physical function and fatigue. Quality of sleep should be questioned in every assessment of patients with lipedema.
Farina G, Santaniello I, Galli M
… +1 more, LoMauro A
Lymphat Res Biol
· 2025 Dec · PMID 41054391
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Lymphedema is a potential chronic degenerative secondary condition of oncologic treatments. Complex decongestive therapy (CDT) is the only treatment. Quantitative dimensional characterization of lymphedema is a topic of...Lymphedema is a potential chronic degenerative secondary condition of oncologic treatments. Complex decongestive therapy (CDT) is the only treatment. Quantitative dimensional characterization of lymphedema is a topic of great clinical interest that has not been sufficiently analyzed yet. We aimed to develop statistical models that evaluate lymphedema's local spatial distribution and the effectiveness of CDT. Retrospective observational analysis of 74 individuals (220 medical records) with unilateral upper or lower limb lymphedema who completed at least one cycle of the first phase of CDT. Statistical mixed-effects models were used to quantify the local distribution of lymphedema through the circumference of eight detection points and the efficacy of CDT according to the entity and the etiology of lymphedema. The coefficients of the models considered both fixed (i.e., the effect at the population level) and random (i.e., subject) effects. All points significantly reduced between pre- and posttreatment. Lymph stagnation occurred in the forearm and below the knee. The dimensions and effective treatment were similar between primary and secondary lymphedema and between mild and moderate lymphedema. The median global volume reduction of the upper limb was 55.1%, while it was 55%, 44.8%, and 41.7% in mild, moderate, and severe lymphedema; 50.6% and 49.4% in primary and secondary lymphedema. The median global volume reduction of the lower limb was 49.5%, while it was 64%, 49.4%, and 48.2% in mild, moderate, and severe lymphedema. A modeling of lymphedema distribution was provided, finding a dysmorphic pattern driven by the gravitation effect, with lymphedema accumulating on the lower part of the limbs, which is also the part that mostly responded to CDT. The response to CDT was assessed locally and not in terms of global volume change. A new segmental proportional technique was proposed that allows making comparisons between and within subjects.
Zapata-Ospina A, Zapata-Ospina JP, Zapata-Ospina D
… +1 more, Rincón-Riano D
Lymphat Res Biol
· 2025 Dec · PMID 41027402
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Lymphedema is a chronic, intractable, and irreversible disease. It consists of insufficiency of the lymphatic vessels to transport lymph, leading to edema and fibrosis. In developing countries and Colombia, the current p...Lymphedema is a chronic, intractable, and irreversible disease. It consists of insufficiency of the lymphatic vessels to transport lymph, leading to edema and fibrosis. In developing countries and Colombia, the current prevalence of lymphedema is unknown. A descriptive cross-sectional study based on population registries. Secondary sources available in Colombia for epidemiological surveillance were revised, and period and point prevalences were calculated. A total of 49,185 cases with a diagnosis of lymphedema were identified in Colombia between 2015 and 2020, resulting in a prevalence of 96.6 cases per 100,000 inhabitants for this period. An increase in the annual point prevalence was found from 2015 to 2019. Lymphedema is more prevalent in women and in the population over 60 years of age. Postmastectomy lymphedema is more prevalent in people aged 60 years or older, and a differential distribution among the different regions of the country was observed. It is the first known prevalence study of lymphedema in Colombia. It shows that the frequency of the disease is increasing, mostly secondary lymphedema, which mainly affects women and people over 35 years of age.
Mahler J, Keeley V, Obed D
… +3 more, Bingöl A, Vogt PM, Hadamitzky C
Lymphat Res Biol
· 2025 Dec · PMID 40996112
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Lipedema, a chronic condition affecting mostly women, involves painful bilateral increase of subcutaneous adipose tissue. The societal impact of this disease is still poorly understood. This study aimed to validate the L...Lipedema, a chronic condition affecting mostly women, involves painful bilateral increase of subcutaneous adipose tissue. The societal impact of this disease is still poorly understood. This study aimed to validate the Lymphedema Quality-of-Life Questionnaire (LYMQOL) for lipedema patients in Germany, assessing its feasibility, reliability, and validity. A total of 81 German-speaking stage II lipedema patients were asked to complete both the LYMQOL (arm and leg versions) and the Short Form Health Survey (SF-36) questionnaires twice, and this was 2 weeks apart. Feasibility was evaluated through response rates, scale structure via factor analysis, validity through SF-36 correlations, and reliability through internal consistency and test-retest reliability analysis. A valid 68% response rate was achieved. Both arm and leg versions demonstrated construct validity with significant correlations to SF-36 subscales. Internal consistency for the leg version was acceptable to excellent, and good to excellent for the arm version. Test-retest reliability was very good for both versions. This study validates the LYMQOL as a robust tool for assessing lipedema patients' quality of life, and also validates the German translation contained in this article. We hope to fill a critical research gap and support future clinical studies aiming at enhancing patient care.
Lymphat Res Biol
· 2025 Dec · PMID 40996101
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Gradient compression garments are a standard treatment for lower limb lymphedema. However, few reports exist on the indications, effectiveness, and limitations of a biker shorts-style compression garment providing only p...Gradient compression garments are a standard treatment for lower limb lymphedema. However, few reports exist on the indications, effectiveness, and limitations of a biker shorts-style compression garment providing only proximal local compression of the thigh and lower abdomen for lymphedema treatment. This pilot study aimed to investigate the therapeutic effects of using biker shorts-style compression garments for lower limb lymphedema treatment. We retrospectively analyzed 40 limbs that received treatment using biker shorts-style compression garments. The primary endpoint was the volume change in the thigh (compression region) and the lower leg (non-compression region) after 6 months of using biker shorts-style compression garments. The control was the volume change in the same patients during an equivalent time period when gradient compression garments were worn. Changes in lymphedema-related symptoms and patients' subjective comments were secondary endpoints. Of the 40 limbs analyzed, 33 limbs were early-stage cases classified as stage 1 or lower by the International Society of Lymphology. Twenty-one limbs had pain and heaviness associated with lymphedema in the thigh or groin. After 6 months of using biker shorts-style compression garments, there was a significant reduction in thigh volume compared to that after using gradient compression garments during the same period. Lymph-related pain improved in all limbs. Significantly poorer thigh volume improvement was observed in patients with a missing posterolateral pathway on lymphangiography and a history of radiation therapy. Compared to gradient compression garments, biker shorts-style compression garments may improve thigh volume and symptoms in lower limb secondary lymphedema.
Lymphat Res Biol
· 2025 Dec · PMID 40988520
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The purpose of this study was to clarify how lymphatic vessels and veins change when body position is changed in lower limbs affected by lymphedema. We performed a retrospective study of 18 consecutive patients (33 limb...The purpose of this study was to clarify how lymphatic vessels and veins change when body position is changed in lower limbs affected by lymphedema. We performed a retrospective study of 18 consecutive patients (33 limbs) who underwent lymphaticovenous anastomosis (LVA) for lower limb lymphedema. We performed ultrasound to detect the suitable lymphatic vessels and veins preoperatively, applying the index of D-CUPS (Doppler, Crossing, Uncollapsible, Parallel, and Superficial fascia) to identify lymphatic vessels. We measured the vertical diameter of the lymphatic vessels and veins in each incision site for LVA using ultrasound with the patients lying, sitting, and standing, and a Student's was performed. The mean age of the participants was 61.8 years old, and the mean body mass index was 21.7 (range: 18.3-28.1). Thirty-eight sites on the 30 thighs and 21 sites on the 18 calves were evaluated. The diameter of veins increased significantly when changing from a lying to a sitting or a standing position (thigh: < 0.01, calf: = 0.016 and 0.015, respectively), but lymphatic vessels did not (thigh: = 0.65, calf: = 0.60 and 0.36, respectively). A weak correlation was found between dilatation rates of veins and lymphatic vessels in the calf (r = 0.39, = 0.030). The veins dilated significantly when the body changed from the supine to standing position, but the lymphatic vessels did not. Similar studies with a larger number of cases are desirable in the future.
Suehiro K, Honda S, Harada T
… +6 more, Takeuchi Y, Mizoguchi T, Sakamoto R, Suzuki R, Kurazumi H, Hamano K
Lymphat Res Biol
· 2025 Dec · PMID 40938332
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We aimed to clarify the time-dependent changes in skin hardness in taxane-induced arm swelling. Fifteen patients with unilateral arm swelling that developed during or within 3 months from the termination of postoperativ...We aimed to clarify the time-dependent changes in skin hardness in taxane-induced arm swelling. Fifteen patients with unilateral arm swelling that developed during or within 3 months from the termination of postoperative taxane-containing chemotherapy were studied. The patients were followed up every 3-6 months for 24 months from the initial visit. During each visit, arm circumference and skin hardness were assessed using a scale ranging from 1 (softest) to 7 (hardest). Ultrasonography of the skin and subcutaneous tissues was performed at 0, 6, 12, and 24 months from the initial visit. In the initial visit, the mean skin hardness in the affected and contralateral arms was 3.8 versus 2.8 ( < 0.05) in the medial/lateral upper arm, 5.0 versus 2.8 ( < 0.01) in the medial forearm, and 4.3 versus 2.8 ( < 0.05) in the lateral forearm. In 12 patients whose arm swelling resolved, the difference in skin hardness between the arms disappeared in 9 patients until 9 months from the initial visit, whereas a mild difference in skin hardness persisted in the remaining 3 patients. Even in three patients whose arm swelling persisted, a certain improvement was observed until 9-12 months from the initial visit. We found that the majority of skin hardening associated with taxane-induced arm swelling improved until approximately 9-12 months from the initial visit, including complete resolution in 60% of patients.
Matsunaga-Myoji Y, Fujita K, Tanaka S
… +3 more, Izumi M, Hirata U, Kato K
Lymphat Res Biol
· 2025 Oct · PMID 40932689
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Lower-limb lymphedema (LLL) secondary to gynecological cancer is a serious health condition that negatively affects physical activity (PA). We investigated the association between objectively measured PA and lymphedema m...Lower-limb lymphedema (LLL) secondary to gynecological cancer is a serious health condition that negatively affects physical activity (PA). We investigated the association between objectively measured PA and lymphedema markers in patients with LLL after gynecological cancer treatment. This cross-sectional study included 56 patients (mean age: 62.0 years) with LLL attending a lymphedema center. The degree of lymphedema was evaluated based on lower-limb water content (extracellular water content/whole body water content: ECW/TBW). The amount and intensity of PA were measured using an accelerometer. Thirty-three patients (61.1%) with ECW/TBW ≥0.4 were older, had significantly more sedentary time, and spent lesser time on moderate-to-vigorous activity than patients with ECW/TBW <0.4 ( < 0.05). A generalized linear model using the rate of change in ECW/TBW showed an association with older age, longer time since cancer diagnosis, and lower activity level. The severity of subjective symptoms measured using a visual analog scale did not differ between patients with high and low ECW/TBW. Patients with LLL spent approximately half of the time in sedentary behavior, with more severe cases exhibiting longer sedentary durations. In older patients who have a long-standing cancer diagnosis, medical professionals should evaluate their activity and self-care status in addition to evaluating LLL and use this information to provide individualized interventions.
Teng J, Martini J, Kelly M
… +2 more, Tollefson M, Greer A
Lymphat Res Biol
· 2025 Dec · PMID 40928941
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Venous malformations can cause substantial morbidity and long-term complications. There are no Food and Drug Administration (FDA)-approved therapies for the treatment of venous malformations. However, off-label use of si...Venous malformations can cause substantial morbidity and long-term complications. There are no Food and Drug Administration (FDA)-approved therapies for the treatment of venous malformations. However, off-label use of sirolimus has demonstrated clinical benefit in these patients. This systematic review evaluates the efficacy and safety of sirolimus in the management of venous malformations. A systematic literature search identified 26 studies comprising 98 patients treated with sirolimus for venous malformations. Most studies were case reports or case series (77%), with 15% prospective trials and 8% retrospective analyses. Sirolimus, primarily administered orally, yielded some level of clinical improvement in 72% of reported patients, with consistent symptomatic relief observed in coagulopathy, bleeding, anemia, pain, and improved function. However, reduction in the size of the malformation varied and treatment-limiting side effects were observed. Oral sirolimus is a promising treatment option for venous malformations, especially for those with deep venous malformations. A direct, targeted topical treatment could provide clinical benefit for the cutaneous manifestation without the risk of off-target effects as occur with oral sirolimus. Further prospective, controlled studies are warranted to elucidate sirolimus's role in managing venous malformations.
Lymphat Res Biol
· 2025 Oct · PMID 40844407
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Lymphedema, a common side effect of breast cancer treatments, affects 20%-40% of patients. Ultrasound evaluation measures structural change as well as skin and subcutaneous tissue thicknesses to assess lymphedema severit...Lymphedema, a common side effect of breast cancer treatments, affects 20%-40% of patients. Ultrasound evaluation measures structural change as well as skin and subcutaneous tissue thicknesses to assess lymphedema severity. This study aimed to investigate the usefulness of ultrasound evaluation as an outcome measure of lymphedema in patients with breast cancer. Thirty-one patients with unilateral breast cancer-related lymphedema were enrolled. Arm circumferences were measured at four points, as the Relative Metric Coefficient of Arm Lymphedema (RMCAL). The thickness of the skin and subcutaneous tissue was measured using ultrasound at four points of the upper arm and forearm, comparing both sides. Subcutaneous echogenicity grade (SEG) and subcutaneous echo-free space (SEFS) grade were assessed following the method described by Suehiro et al. Lymphoscintigraphy evaluated axillary lymph node uptake and dermal backflow. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module 23 (EORTC QLQ-BR23). Increase ratios of skin and subcutaneous tissue thickness, SEG, and SEFS were well correlated with RMCAL value. Additionally, the increase ratio of subcutaneous tissue was significantly different according to the abnormality of axillary lymph node uptake on lymphoscintigraphy. However, ultrasound parameters did not significantly associate with functional and symptom scales of EORTC QLQ-BR23. Ultrasound parameters were well correlated with arm circumferences. Furthermore, subcutaneous tissue thickness on ultrasound was significantly related to lymphatic function assessed by lymphoscintigraphy.
Doubblestein D, Fay D, Brunskill S
… +2 more, Westbrook B, Williams B
Lymphat Res Biol
· 2025 Oct · PMID 40790532
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To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema. A retrospective cohort study was co...To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema. A retrospective cohort study was conducted using rehabilitation records of children aged 5-17 years from Camp Watchme, a North American summer camp providing lymphedema interventions. Over 4 years, 38 unique campers contributed 66 records for analysis. The majority were female (68.42%), with a mean age of 9.30 ± 2.66 years. Lower extremity limb volume demonstrated statistically significant reductions across all 4 years (2021, = 0.011; 2022, = 0.030; 2023, < 0.001; 2024, < 0.001). Cumulative analysis of upper extremities ( = 16) also showed significant volume reduction ( = 0.042, = 0.50). Daily measurement tracking ( = 43) indicated consistent percent volume decreases, with confidence intervals supporting a meaningful change for lower extremity limb volume differences across 4 years. An intensive, short-duration CDT intervention significantly reduces limb volume in pediatric patients with lymphedema. Future research should explore long-term effects, optimize CDT protocols, and assess broader functional and psychosocial outcomes to enhance pediatric lymphedema management.