Hot of the Press February 2025
Article to ponder
ICGL shows great promise as a diagnostic tool for lymphoedema due to its non-ionising nature and cost-effectiveness. However, uncertainty remains because studies lack thorough patient phenotyping and genotyping. Key imaging patterns like splash, starburst, and diffuse dermal rerouting need further validation. Future research should focus on standardised imaging protocols and genetically confirmed primary lymphoedema cases to refine its diagnostic value.
A Systematic Review of Indocyanine Green Lymphography (ICGL) Imaging for the Diagnosis of Primary Lymphoedema
G Brezgyte, M Mills, M van Zanten, K Gordon, P S Mortimer, P Ostergaard, British Journal of Radiology, 2025;, tqaf006, https://doi.org/10.1093/bjr/tqaf006
Key Takeaway: ICGL has the potential to enhance lymphoedema diagnosis and treatment monitoring, but inconsistent protocols and reporting limit its current utility.
We have collated some great articles and material published over the last month. Click on the links below to read the abstract or download the full paper.
Anatomy / Physiology /Pathophysiology
Primary Lymphedema: Anatomically Isolated or a Pervasive Systemic Disorder?
The impact of lymphedema severity on shoulder joint function and muscle activation patterns in breast cancer survivors: a cross-sectional study.
Mohamed, M.H., Radwan, R.E., ElMeligie, M.M. et al. Support Care Cancer 33, 37 (2025).
Unveiling global interest in lymphedema: A decade of search data through google trends global interest in lymphedema: A google trends analysis - click for abstract
Unveiling global interest in lymphedema: A decade of search data through google trends global interest in lymphedema: A google trends analysis
Prevalence and Risk Factors
Non-contrast MRI based machine learning and radiomics signature can predict the severity of primary lower limb lymphedema
Perceived Psychological and Physical Health as Predictors of Mortality and Quality of Life in Patients with Lymphedema: A Prospective Study Spanning Almost Two Decades.
Loibnegger-Traußnig, K., Schwerdtfeger, A.R. & Flaggl, F Int.J. Behav. Med. (2024). https://doi.org/10.1007/s12529-024-10340-z
Assessment
Assessing Tissue Dielectric Constant Values in Tumor Bearing and Healthy Breasts - click for abstract
Assessing Tissue Dielectric Constant Values in Tumor Bearing and Healthy Breasts
Background: This study aimed to investigate, characterize, and provide quantitative reference data on tissue dielectric constant (TDC) values of female breasts when measurements were made to 5 mm depths and determine the utility of these measurements to differentiate between benign and malignant breast tumors.
Methods and Results: Breast TDC was measured bilaterally in 82 women just prior to an ultrasound-guided diagnostic biopsy of one tumor in one breast. TDC was measured in triplicate over the tumor and the contralateral healthy breast. Considering all paired breasts, the average TDC (mean ± SD) for healthy breasts was less than for tumor-bearing breasts (26.7 ± 4.5 vs. 29.9 ± 8.5, p = 0.0003).
Conclusions: Breast TDC values measured to 5 mm in 82 healthy nonedematous breasts provide a two-SD threshold reference value of 35.7. This represents a TDC value above which the presence of breast edema/lymphedema may be indicated based on the two-SD threshold criterion. For unilateral cases, an interbreast TDC ratio exceeding 1.275 may be considered a breast edema/lymphedema indicator also based on the two SD criteria used. These thresholds may have utility for early detection and to track breast edema/lymphedema changes. A comparison of these TDC values obtained from benign versus malignant tumors indicates no statistically significant difference between them. However, interbreast TDC ratios were statistically higher for breasts with malignant versus benign tumors. However, the large overlap of the ratio values renders this method of discrimination between benign vs. malignant tumors inadequate based on the present findings.:10.1089.0061
Measurement Properties and Determinants of the 6-Minute Walk Test in Patients with Lower Limb Lymphedema - click for abstract
Measurement Properties and Determinants of the 6-Minute Walk Test in Patients with Lower Limb Lymphedema
The Comparative Frequency of Breast Cancer-Related Lymphedema Determined by Perometer and Circumferential Measurements: Relationship with Functional Status and Quality of Life - click for abstract
The Comparative Frequency of Breast Cancer-Related Lymphedema Determined by Perometer and Circumferential Measurements: Relationship with Functional Status and Quality of Life
Evaluation of Long-Term Lymphedema Rate in Patients With Subclinical Lymphedema Diagnosed in the Preoperative Period via Bioimpedance
Indocyanine Green Lymphography in Conservative Lymphedema Management: An Exploration of the Impact on Lymphedema Therapy Plans
Megan Trevethan, Emmah Doig, Freyr Patterson, Amanda Pigott,. Seminars in Oncology Nursing,
2024,
Quantifying the Impact of Axillary Surgery and Nodal Irradiation on Breast Cancer-Related Lymphedema and Local Tumor Control: Long-Term Results From a Prospective Screening Trial - click for abstract
Quantifying the Impact of Axillary Surgery and Nodal Irradiation on Breast Cancer-Related Lymphedema and Local Tumor Control: Long-Term Results From a Prospective Screening Trial
Naoum GE, Roberts S, Brunelle CL, Shui AM, Salama L, Daniell K, Gillespie T, Bucci L, Smith BL, Ho AY, Taghian AG. J Clin Oncol. 2020 Jul 30
PURPOSE: To independently evaluate the impact of axillary surgery type and regional lymph node radiation (RLNR) on breast cancer-related lymphedema (BCRL) rates in patients with breast cancer.
PATIENTS AND METHODS: From 2005 to 2018, 1,815 patients with invasive breast cancer were enrolled in a lymphedema screening trial. Patients were divided into the following 4 groups according to axillary surgery approach: sentinel lymph node biopsy (SLNB) alone, SLNB+RLNR, axillary lymph node dissection (ALND) alone, and ALND+RLNR. A perometer was used to objectively assess limb volume. All patients received baseline preoperative and follow-up measurements after treatment. Lymphedema was defined as a ≥ 10% relative increase in arm volume arising > 3 months postoperatively. The primary end point was the BCRL rate across the groups. Secondary end points were 5-year locoregional control and disease-free-survival.
RESULTS: The cohort included 1,340 patients with SLNB alone, 121 with SLNB+RLNR, 91 with ALND alone, and 263 with ALND+RLNR. The overall median follow-up time after diagnosis was 52.7 months for the entire cohort. The 5-year cumulative incidence rates of BCRL were 30.1%, 24.9%, 10.7%, and 8.0% for ALND+RLNR, ALND alone, SLNB+RLNR, and SLNB alone, respectively. Multivariable Cox models adjusted for age, body mass index, surgery, and reconstruction type showed that the ALND-alone group had a significantly higher BCRL risk (hazard ratio [HR], 2.66; P = .02) compared with the SLNB+RLNR group. There was no significant difference in BCRL risk between the ALND+RLNR and ALND-alone groups (HR, 1.20; P = .49) and between the SLNB-alone and SLNB+RLNR groups (HR, 1.33; P = .44). The 5-year locoregional control rates were similar for the ALND+RLNR, ALND-alone, SLNB+RLNR, and SLNB-alone groups (2.8%, 3.8%, 0%, and 2.3%, respectively).
CONCLUSION: Although RLNR adds to the risk of lymphedema, the main risk factor is the type of axillary surgery used
Measurement Properties and Determinants of the 6-Minute Walk Test in Patients with Lower Limb Lymphedema l - click for abstract
Measurement Properties and Determinants of the 6-Minute Walk Test in Patients with Lower Limb Lymphedema
Management Strategies
Safety Evaluation of a Device for Treatment of Lymphedema of the Upper Extremity - click for abstract
Safety Evaluation of a Device for Treatment of Lymphedema of the Upper Extremity
Interventions for Prevention and Management of Gynecological Cancer-Related Lower Limb Lymphedema: A Systematic Scoping Review - click for abstract
Interventions for Prevention and Management of Gynecological Cancer-Related Lower Limb Lymphedema: A Systematic Scoping Review
Feasibility and efficacy of home-based lymphedema exercises for head and neck cancer patients at a safety net hospital - click for abstract
Feasibility and efficacy of home-based lymphedema exercises for head and neck cancer patients at a safety net hospital
Development and evaluation of a WeChat-based intervention program for prevention of breast cancer-related lymphedema - click for abstract
Development and evaluation of a WeChat-based intervention program for prevention of breast cancer-related lymphedema
Demonstration of the effectiveness of complete decongestive treatment in secondary lymphedema developing after total knee arthroplasty - click for abstract
Demonstration of the effectiveness of complete decongestive treatment in secondary lymphedema developing after total knee arthroplasty
Complex Decongestive Therapy Improves Gait Speed in Patients with Lower Limb Lymphedema - click for abstract
Complex Decongestive Therapy Improves Gait Speed in Patients with Lower Limb Lymphedema
E Gökçe, N Gün, Ü Düzlü Öztürk, M Dalyan – Lymphatic Research and Biology, 2024