Hot of the Press March 2026

Article to ponder

A recent Australian study in the Journal of Psychosomatic Research found that although women with lipoedema and bilateral leg lymphoedema report similar overall quality of life, those with lipoedema experience significantly greater burden related to mood, appearance, symptoms, and access to support.

A retrospective cross-sectional study comparing health-related quality-of-life in females with lipoedema and bilateral leg lymphoedema.

Stellmaker, R., Thompson, B., Mackie, H., Paramanandam, V. S., Sherman, K. A., & Koelmeyer, L. (2026).Journal of Psychosomatic Research, 112562.

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Key Takeaway: Lipoedema was associated with worse mood, appearance, and symptom impact compared to bilateral leg lymphoedema.

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

Lymphatic pumping failure in the arm precedes dermal backflow and breast cancer-related lymphedema

Melissa B. Aldrich, Meghan E. McWain, Simona F. Shaitelman, Rian E. Kuhns, John C. Rasmussen, Wendy A. Woodward, Sarah M. DeSnyder, Wenyaw Chan & 

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Identification of a Cytokine Biomarker for Prognostic Modeling of Breast Cancer-Related Lymphedema

Alison J. Wu, Neil Lin, Jie Su, Cherie Lin, Madison-Shira Hossack, Wei Shi, Farnoosh Abbas-Aghababazadeh, Wei Xu, Benjamin Haibe-Kains, Simona F. Shaitelman, Melissa B. Aldrich, Fei-Fei Liu, Jennifer Y.Y. Kwan. Cancer Res Commun. 2026 Feb 5

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Lymphatic pumping failure in the arm precedes dermal backflow and breast cancer-related lymphedema

Melissa B. Aldrich, Meghan E. McWain, Simona F. Shaitelman, Rian E. Kuhns, John C. Rasmussen, Wendy A. Woodward, Sarah M. DeSnyder, Wenyaw Chan, Eva M. Sevick-Muraca. Breast Cancer Res. 2026 Feb 17.

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Characterizing forearm skeletal muscle composition and function in breast cancer-related lymphedema using B-mode ultrasonography

Jesse Whyte, Anna Towers, Mathieu Boily, Leonard Rosenthall, Hassan Rivaz, Robert D. Kilgour. Clin Physiol Funct Imaging. 2026 Feb 12.

BACKGROUND: Skeletal muscle thickness, echo intensity, and quality are important morphological properties; however, little is known how these variables compare between the affected and unaffected forearms in breast cancer-related lymphedema (BCRL).

METHODS: Using B-mode ultrasound, we recorded the raw radiofrequency data of the affected and unaffected forearms of women (n = 20) with Stage 2 BCRL, and in a control group of 20 women with no lymphedema. The data were converted into images and measurements of skin, subcutaneous fat, and muscle thickness were obtained. Within a designated region of interest, muscle echo intensity was assessed using computer graded grey scale and muscle thickness was measured using ImageJ2. Handgrip strength was measured using standard dynamometry.

RESULTS: We found no differences in muscle thickness among affected, unaffected, and control forearms. The affected arm had significantly lower (p ≤ 0.025) muscle quality than controls but similar to values found in the unaffected arms. The affected arm had higher muscle echo intensity than the unaffected (p ≤ 0.013) and control (p ≤ 0.001) arms. Muscle echo intensity was related to subcutaneous fat thickness (r = 0.45; p ≤ 0.05) and arm circumference (r = 0.47; p = 0.04) in the affected arm in women with lymphedema.

CONCLUSIONS: Lymphedema does not negatively affect forearm muscle thickness. The elevated levels of muscle echo intensity of the affected arm does not influence muscle quality in BCRL. The functional relevance of an elevated muscle echo intensity in the affected arm and its relationship with arm circumference and subcutaneous fat thickness needs to be further explored.:10.1111

Prevalence and Risk Factors

A Retrospective Analysis of Correlations Between Shoulder Impairment and Ultrasound Lymphedema Evaluation in Breast Cancer Patients: Preliminary Results

Gianpaolo Ronconi, Rossella Calciano, Alberto Cutaia, Mariantonietta Ariani, Elisabetta Lama, Lucia Forastiere, Sara Corsini, Paola Emilia Ferrar. Biomedicines. 2026 Jan 5

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Assessment

The relationship between impaired upper-body function, quality of life and breast cancer-related lymphoedema: results from a prospective, population-based cohort study

Hildegard M. Reul-Hirche, Matthew R. Dunn, Melanie L. Plinsinga, E-Liisa Laakso, Melissa A. Troester, Sandra C. Hayes. Breast Cancer Res Treat. 2026 Feb 4.

PURPOSE: To describe upper-body function in women after breast cancer treatment; and to explore the relationship between upper-body function, quality of life and breast cancer- related lymphoedema up to 7-years post-diagnosis.
METHODS: This study uses data collected in a prospective, longitudinal, population-based, breast cancer cohort study. The Disability of Arm, Shoulder and Hand questionnaire (short version -QuickDASH), the Functional Assessment of Cancer Therapy-Breast questionnaire (FACT-B) and self-report of a clinical diagnosis were used to assess upper-body function, quality of life and breast cancer-related lymphoedema, respectively, in 2,876 women with invasive breast cancer at three time points: baseline (up to 9 months post-diagnosis), and at 2- and 7-years post-diagnosis. Unadjusted cross-sectional relationships between outcomes of interest were tested at each time point. Unadjusted and adjusted regression analyses were used to explore the potential predictive relationship between upper-body function and lymphoedema.
RESULTS: Upper-body impairment was common up to 7-years post-diagnosis with > 60% of women reporting at least mild impairment and 23.8-25.6% reporting moderate to very severe impairment. Impaired upper-body function at baseline assessment was associated with poorer overall quality of life (mean (standard deviation) FACT-B for no versus mild impairment: 77.5 (11.8) versus 70.9 (12.1), p < 0.05) and increased odds of breast cancer-related lymphoedema at 2 and 7 years follow-up (moderate to severe upper-body function impairment at 2- and 7- years post-diagnosis: Odds Ratio (95% Confidence interval) 2.49 (1.57, 3.93) and 2.54 (1.51, 4.26), respectively).
CONCLUSION: Future research evaluating whether prospective monitoring of upper-body function and interventions that can address impairment can reduce the risk of breast cancer-related lymphoedema are warranted.:10.1007

Duplex ultrasound evaluation in lymphedema: Pictorial essay

Luca Palombi, Fabio Martinelli, Ali Ahmad Chraim, Roberto Parisi, Luca Ferretto, Monica Morelli. Phlebology. 2026 Feb 12.

Introduction: Lymphedema is a chronic and progressive condition resulting from impaired lymphatic drainage, leading to protein-rich fluid accumulation, tissue remodeling, and fibrosis. It represents a relevant public health issue worldwide, with substantial functional and psychosocial impact. This pictorial essay aims to illustrate the role of ultrasound in the assessment of lymphedema and to describe sonographic features that assist in distinguishing early from advanced disease stages.
Methods: This exploratory pictorial essay is based on representative cases of upper- and lower-limb lymphedema examined in routine clinical practice. High-frequency ultrasound probes (18-21 MHz) were used with B-mode imaging, colour Doppler, power Doppler, micro-flow presets, elastosonography, and AI-assisted image optimisation. The examination focused on skin, subcutaneous tissue, lymphatic channels, and their dynamic behaviour during provocation manoeuvres. No quantitative measurements or statistical analyses were performed.
Results: Distinct patterns of oedema distribution were observed on ultrasound. Mild lymphedema was characterised by predominantly vertical diffusion of fluid from the dermis toward the superficial fascial plane, whereas moderate to severe forms showed horizontal expansion within the subcutaneous compartment, frequently associated with dilated lymphatic lacunae. Lymphatic channels were identifiable as thin-walled, non-compressible structures without inducible flow on colour or power Doppler, even after distal manual compression. Advanced high-frequency imaging enabled visualisation of isoechoic intraluminal material consistent with fibrin deposition in chronically obstructed lymphatic pathways. Elastosonography demonstrated increased stiffness of the deep dermal and subdermal layers in chronic disease.
Conclusion:Ultrasound provides a non-invasive and detailed visual assessment of lymphatic vessels and soft-tissue alterations in lymphedema. When combined with elastosonography and AI-assisted imaging, it facilitates recognition of disease stage and chronicity and supports its role as a valuable tool in the comprehensive evaluation of lymphedema.:10.1177/02683555261426971

Evaluation of Long-Term Lymphedema Rate in Patients With Subclinical Lymphedema Diagnosed in the Preoperative Period via Bioimpedance

Zeynep Erdoğan İyigün, Tolga Ozmen, Serkan İlgün, Cansu Nakipoğlu, Enver Özkurt, Filiz Çelebi, Çağlar Ünal, Alper Öztürk, Gül Alço, Çetin Ordu, Gürsel Soybir. Eur J Breast Health. 2025 Jan 1.

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Local Tissue Water Variations in Women at Risk of Developing Arm Lymphedema Following Breast Cancer Treatment-A Retrospective Study

Katarina Blom, Christina Brogårdh, Lena Nilsson-Wikmar, Helena Sackey, Karin Johansson. Lymphat Res Biol. 2026 Feb 4

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Impact of Lymphedema on Women’s Lives After Gynaecological Cancer: An Integrative Review

Pernille Dehn, Anette Rasmussen, Lene Seibæk, Ragnhild Johanne Tveit Sekse, Anne Marie Thimm, Mette Linnet Olesen. Scand J Caring Sci. 2026 Mar 40

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Screening for post-traumatic lower extremity lymphedema: Patient characteristics, risk factors, and quality of life outcomes

Chelsea A. Allen-Brough, Brett Hahn, Patrick Romijn, Stefan Hummelink, Arne C. Berger, Pim van Egmond, Dietmar J. O. Ulrich, Tim De Jong. J Reconstr Microsurg. 2026 Feb 4

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Management Strategies

Effect of yoga on oedema and quality of life in women with breast cancer-related lymphoedema: a randomised clinical trial

Fatemeh Movafegh, Samira Beigmoradi, Mehdi Ramazanpour, Iman Nosratabadi, Ehsan Soltani-Nejad, Zahra Imani-Goghary. Br J Community Nurs. 2026 Jan 29.

BACKGROUND: Post-mastectomy lymphoedema can lead to limitation in daily activities and have a negative impact on quality of life.AIM: This study explored the effect of yoga exercise on upper limb lymphoedema volume and quality of life in post-mastectomy patients.
METHODS: A total of 112 post-mastectomy patients were recruited for this randomised controlled trial using a purposive sampling method, of whom 96 participants completed the study. Participants were randomly assigned to intervention and control groups. After initial assessments using the volumetric-tank technique and the Lymphedema Life Impact Scale, the intervention group received yoga exercises. Data were analysed using Statistical Package for the Social Sciences software with independent t-test, paired t-test and covariance test.
RESULTS: After the intervention, significant differences were found in upper limb lymphoedema volume and mean scores of the Lymphoedema Life Impact Scale and its physical and functional domains (P<0.05).
IMPLICATIONS FOR PRACTICE: Clinicians and nurses can incorporate blended (in-person and online) yoga programmes into self-management and rehabilitation plans to enhance accessibility and adherence. These findings support allocating resources toward low-cost, adaptable yoga interventions within breast cancer survivorship care pathways.
CONCLUSIONS: Yoga was found to be a safe and effective complementary approach for reducing upper limb lymphoedema in early stages and improving wellbeing in post-mastectomy patients without comorbidities. Further research is needed to evaluate its efficacy in other populations, or in advanced stages of lymphoedema.:10.12968.0019

The Effect of a Mobile-Based Lymphedema Self-care Support Program in Women With Breast Cancer-Related Lymphedema: A Single-blind Randomized Controlled Study

Zeynep Deveci Koçbilek, Özgül Karayurt, Özlem Bilik, Sibel Eyigör. Comput Inform Nurs. 2026 Feb 2.

This single-blind, randomized controlled design study aims to examine the effect of a mobile-based Lymphedema Self-care Support Program on self-care, the quality of life, and lymphedema symptoms in women with breast cancer-related lymphedema. A control group was offered online standard lymphedema education, and an intervention group was provided with the mobile-based Lymphedema Self-care Support Program in addition to the standard education. Outcome measures were self-care, quality of life, lymphedema symptoms, and arm circumference measurements. The intervention and control groups were similar in sociodemographic and clinical features at baseline. Although there was a significant difference in the mean self-care scores between the groups, there was no significant difference in the mean scores on the quality of life and lymphedema symptoms. The mean scores on self-care and the quality of life increased and arm circumferences decreased significantly across time in the intervention group. The mobile-based Lymphedema Self-care Support Program is a beneficial method to enhance self-care and the quality of life and reduce symptoms in women with breast cancer-related lymphedema. Breast cancer survivors can increase their self-care practices, prevent an increase in their symptoms and arm circumferences, and improve the quality of their lives by using the mobile-based Lymphedema Self-care Support Program.:10.1097

A comparison of the static stiffness index between a compression garment and an adjustable device in breast cancer-related lymphoedema: a cross-sectional study

Leila Pereira, Jéssica Malena Pedro da Silva, Suzana Sales de Aguiar, Mauro Figueiredo Carvalho de Andrade, Anke Bergmann. J Wound Care. 2026 Feb 2. Epub 2026 Feb 6.

OBJECTIVE: To compare the static stiffness index (SSI) between a compression garment and a ReadyWrap (Venosan, Brazil) adjustable compression garment (ACG), and analyse the clinical factors associated with increased SSI in patients with breast cancer-related lymphoedema (BCRL).
METHOD: In this cross-sectional study, working pressure (WP) and resting pressure (RP) were assessed using a PicoPress device (Venosan, Brazil) positioned under the biceps muscle in the arm region. The SSI was calculated as the absolute and relative difference between the RP and the highest WP recorded during muscle contraction.
RESULTS: The study included 76 patients with a mean age of 61.7±12.6 years. During compression garment use, the mean RP was 21.9mmHg and mean WP was 40.0mmHg during biceps brachii contraction, resulting in an absolute SSI of 18.1mmHg and a relative SSI of 43.6% (p<0.001). For the ACG, the mean RP was 19.3mmHg and mean WP was 63.1mmHg, resulting in a mean SSI of 43.8mmHg and a relative SSI of 68.7% (p<0.001). The ACG produced an SSI 25.7mmHg greater than the compression garment, a 25.1% relative difference (p<0.001). The compression garment showed a higher SSI in early-stage versus advanced-stage patients (8.2%; p=0.003) and in those with conservative surgeries versus mastectomy (8.3%; p=0.005). No SSI difference was observed for the ACG when considering tumour characteristics and oncological treatment.
CONCLUSION: The SSI was greater with ACG use compared with the compression garment. Patients who had breast-conserving surgeries and early-stage tumours showed the highest SSI when using the compression garment. No SSI differences were found regarding patient demographic, clinical, tumour or treatment characteristics during ACG use.:10.12968.0031

Barriers to Adherence After a Self-Management Lymphedema Education Program Among Women With Breast Cancer-Related Lymphedema: A Qualitative Study

Gizem C. Uçar, Sevgisun Kapucu, Ayşe A. Dönmez, Oya Özdemir. Am J Clin Oncol. 2026 Feb 12.

OBJECTIVES: Lymphedema associated with breast cancer is a chronic condition that negatively affects women’s physical functioning, psychosocial well-being, and quality of life. Although self-management education is a fundamental component of lymphedema care, many women struggle to maintain recommended practices in daily life over time. To explore how women with breast cancer-related lymphedema integrate self-management education into daily life over time and to identify barriers to sustained adherence 1 year or more after completing a self-management lymphedema education program (SMLEP).
METHODS: A descriptive phenomenological qualitative design was used. In-depth, semistructured interviews were conducted with 17 women diagnosed with breast cancer-related lymphedema. Data were analyzed using qualitative content analysis.
RESULTS: Two overarching themes were identified: problems caused by lymphedema and barriers to self-management. Problems included limitations in activities of daily living, pain, restricted social participation, and body image disturbance. Barriers included economic difficulties, decreased belief in treatment effectiveness, boredom and forgetfulness, lack of family support, absence of monitoring mechanisms, use of the dominant arm, and symptom regression. CONCLUSIONS: Women with breast cancer-related lymphedema face interconnected physical, emotional, and contextual challenges that limit long-term self-management adherence beyond knowledge deficits alone.:10.1097

Targeting excessive cholesterol deposition alleviates secondary lymphoedema

Hwee Ying Lim, Yuning Zhang, Syaza Hazwany Mohammad Azhar, Chung Hwee Thiam, Michaela Taylor, Xuan Han Koh, Mohamed Ameen Shah Bin Mohamed Yunos, Shu Wen Tan, Sheau Yng Lim, Wei Siong Ong, Jasmine Goh, Si Hui Ng, Blake J. Cochran, Wai Kin Tham, Owen Ang, Sheng Jie Lim, Tze Chin Lim, Yanjun Chen, Sebastian Frederik Mause, Federico Torta, Markus R. Wenk, Kerry-Anne Rye, Bien Keem Tan, Veronique Angeli. Nature. 2026 Feb 11.

Lymphoedema is a chronic debilitating disease caused by impaired lymphatic drainage and is characterized by tissue swelling, fat expansion, inflammation and fibrosis1,2. However, the exact mechanisms that drive lymphoedema are poorly understood. Although lymphatic vessels are known to transport cholesterol from peripheral tissues back to the systemic circulation3, the importance of impaired lymphatic drainage for cholesterol clearance in humans and its relevance to lymphoedema remain unknown. Here we show that lymphatic drainage insufficiency in human lymphoedema leads to excessive cholesterol accumulation in the lymphoedematous dermal tissue and around lymphatic vessels. Cholesterol deposition resulted in dermal adipose tissue remodelling, characterized by adipocyte hypertrophy and dysfunction, progressing to death and dermal fibrosis. Surgical intervention improved lymphatic drainage and reduced cholesterol deposition. Using two mouse models that reproduce features of human lymphoedema, we demonstrated that tissue swelling and dermal adipose tissue remodelling were ameliorated by the cholesterol-depleting agent cyclodextrin. Mechanistically, we demonstrated that cyclodextrin restored lymphatic drainage by promoting the regeneration of lymphatic vessels. This study unravels the role of impaired cholesterol clearance in driving lymphoedema and identifies tissue cholesterol as a promising therapeutic target for this currently incurable disease.:10.1038

Lymphedema Education Advocacy Program (LEAP): Addressing Gaps in Patient Education of Breast Cancer-Related Lymphedema (BCRL)

Sophia Braithwaite, Zeinab A. Mohamed, Anna Revette, Brett Nava-Coulter, Jenna Dobbins, Samantha Ramos, Meghan Little, Kathryn Paschalis, Ann Olzinski-Kunze, Jessica Gooch, Kimberly Gergelis, Daniel Kim, Anna Weiss. J Surg Res. 2026 Feb 18.-8.

INTRODUCTION: Breast cancer-related lymphedema (BCRL) is a noncurable condition that is underdocumented and underrecognized. This study assesses the effectiveness of BCRL education at the first postoperative visit, via qualitative research methods, with the goal of establishing an effective BCRL educational protocol. We hypothesized that the current BCRL education provided is insufficient, and patients would benefit from a standardized, more comprehensive educational protocol to improve BCRL understanding.
MATERIALS AND METHODS: Patients received standardized written educational materials about BCRL in the preoperative setting. Participants in this study were patients who had a sentinel lymph node biopsy or axillary lymph node dissection. Semi-structured interviews were conducted during postoperative appointments. The purpose was to identify knowledge gaps, emotional responses, follow-up preferences, and preferred educational methods among patients. Data were analyzed using manual qualitative research methods to derive themes.
RESULTS: Sixteen patients participated in interviews during June-September 2024, with a median age of 53 y (range 29-67 y). Of the participants, 31% were African American/Black and 69% were Caucasian, with 6% identifying as Hispanic. Thirteen patients (81%) underwent breast-conserving surgery and three (19%) underwent mastectomy; 88% underwent sentinel lymph node biopsy and 13% underwent axillary lymph node dissection. Themes that emerged included (1) familiarity with lymphedema, (2) understanding lymphedema risk, (3) receiving contradictory information, (4) emotional distress, (5) recognizing varying preferences for educational materials, and (6) acknowledging varying levels of medical literacy.
CONCLUSIONS: This study highlights the importance of health-care providers delivering timely and personalized BCRL education, along with continued education and counseling during survivorship.:10.1016/j.jss.2026.01.019

Impact of Body Mass Index on the Outcomes of Intensive Complex Decongestive Therapy for Lower Limb Lymphedema

Marie Warnier, Nina Antoniolli, Benoit Bihin, Jacqueline Frippiat, Chloé Meseeuw, Alexis Lheureux, Thierry Deltombe. Int J Vasc Med. 2026 Jan 27

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