Hot of the Press May 2026

Article to ponder

AI-based models show strong performance in predicting, detecting, and grading breast cancer–related lymphedema, often achieving high accuracy by integrating clinical data, imaging, and patient-reported outcomes. These approaches highlight the potential for earlier detection and more personalized management, but broader clinical adoption is constrained by limited dataset sizes, inconsistent validation, and challenges with model interpretability.

Artificial Intelligence In The Diagnosis And Prediction Of Breast Cancer-Related Lymphedema: A Scoping Review

S Kagan, L Huynh, D Chen, C Strickland, C Yang… – Supportive Care in Cancer, 2026

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Key Takeaway:

AI shows strong promise for early and accurate detection of breast cancer–related lymphedema, but better data quality, validation, and transparency are needed before routine clinical use.

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

Lymphedema: The Overlooked Cardiovascular Disorder-Mechanisms, Manifestations, and Management

Tobias Whitford, David Haner Wasserstein, Harris Whiteson, William H. Frishman. Cardiol Rev. 2026 Apr 2.

Lymphedema, a chronic disorder resulting from impaired lymphatic drainage, is increasingly recognized for its significant relevance to cardiovascular medicine. Its fundamental role in regulating systemic fluid homeostasis and inflammation positions it as a key factor in the pathophysiology of many cardiovascular conditions. This review aims to summarize the fundamental mechanisms of lymphatic dysfunction, elucidate its direct cardiovascular implications, and outline current and emerging management strategies. The content is tailored for a cardiology-focused audience to bridge the gap between peripheral lymphatic medicine and mainstream cardiovascular practice. Lymphatic dysfunction contributes to a cascade of pathological changes, including systemic and interstitial fluid overload, chronic inflammation, progressive tissue fibrosis, and adipose deposition. There is a critical, reciprocal relationship between lymphatic failure and cardiovascular conditions. Specifically, lymphatic dysfunction can exacerbate heart failure and impair postmyocardial infarction recovery, while conditions such as chronic venous disease and right heart failure directly overload and damage the lymphatic system, creating a vicious cycle of fluid accumulation. Lymphedema is an underrecognized systemic vascular condition, not merely a peripheral disorder of swelling. Integrating lymphatic assessment into routine cardiovascular practice could be beneficial for accurately diagnosing fluid overload states and mitigating the systemic inflammatory consequences of lymphatic failure. Early diagnosis and multidisciplinary management are crucial for improving outcomes in patients with cardiovascular disease.:10.1097

Genome-Wide Association Study of Chronic Venous Insufficiency and Lymphedema in the Million Veteran Program

Gina M. Peloso, Nimish Adhikari, Melissa M. Young, Kelly Cho, Scott Kinlay, VA Million Veteran Program. Circ Genom Precis Med. 2026 Apr 2.

BACKGROUND: Lymphedema is a chronic condition characterized by the accumulation of fluid due to impaired lymphatic drainage, frequently occurring secondary to chronic venous insufficiency (CVI), malignancy, or obesity. Despite known environmental and clinical risk factors, the genetic contributors to lymphedema and CVI have been understudied.
METHODS: We conducted a multipopulation genome-wide association study in participants of the Million Veteran Program without cancer to identify genetic variants associated with CVI, lymphedema, and their cooccurrence. Individuals were categorized into 3 case groups: CVI only (n=34 664), lymphedema only (n=2452), and lymphedema+CVI (n=3283) and were compared with 367 684 controls.
RESULTS: We identified 11 genome-wide significant variants (P<5×10-8) in the multipopulation analysis, including 8 for CVI only, 1 for lymphedema only, and 2 for lymphedema+CVI, and 2 population-specific genetic variants. Three independent variants replicated in the UK Biobank for CVI only near CASZ1, SLC12A2, and NDP. Polygenic risk scores derived from the Million Veteran Program were associated with CVI in the UK Biobank and phenome-wide associations of CVI-associated variants revealed pleiotropic associations with cardiometabolic traits.
CONCLUSIONS: These findings enhance our understanding of the genetic architecture of lymphatic dysfunction.:10.1161.005442

Prevalence and Risk Factors

Exploring the Influencing Factors of Quality of Life During Maintenance Phase in Patients With Breast Cancer-Related Lymphedema

None Zebing Luo Msn, None Manjia Xu Bns, None Shuxian Yu Bns, None Weijie Gao Bns, None Xinxian Lv Bns, None Chujun Chen Bns. Oncology (Williston Park). 2026 Mar 16.-122.

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Minimizing Early-Onset Lymphedema Following Groin Dissection in Metastatic Melanoma

Melody Brown, Teresa S. Lee, Isabel Li, Christopher Allan. Ann Surg Oncol. 2026 Apr 13

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Prevention of breast cancer-related lymphedema by progressive resistance training – a long-term follow-up of a randomized controlled trial

Gunn Ammitzbøll, Marie Lillegaard, Christoffer Johansen, Charlotte Lanng, Kathrine Grell, Niels Kroman, Bo Zerahn, Ole Hyldegaard, Merete Celano Wittenkamp, Susanne Oksbjerg Dalton. J Cancer Surviv. 2026 Apr 9. 

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Lymphedema and self-reported swelling among Danish survivors of prostate cancer – prevalence, clinical associations and functional implications

Anne Katrine Graudal Levinsen, Gunn Ammitzbøll, Trille Kristina Kjaer, Michael Borre, Signe Benzon Larsen, Susanne Oksbjerg Dalton. Support Care Cancer. 2026 Apr 15

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Trajectories of lymphedema risk perception and their predictors in postoperative breast cancer survivors

Yaru Yang, Yu An, Mengyu Han, Jingming Lu, Zhiqiang He, Tianyu Wang, Hui Xiao, Junxia Ye, Jingyu Chen, Jin Li. J Cancer Surviv. 2026 Apr 22

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The Risk of Lymphedema in Elective Hand Surgery After Axillary Lymph Node Sampling: A Prospective, Cohort Study

Susan M. Odum, Casey Sabbag, Warren Hammert, Daniel R. Lewis, Bryan J. Loeffler, Christopher Chadderdon, Kevin C. Chung, Thomas Lehman, R. Glenn Gaston. Hand (N Y). 2026 Mar 27.

BACKGROUND: The purpose of this prospective cohort study was to evaluate the risk of lymphedema and perioperative complications in patients undergoing elective upper-extremity surgery with a history of breast cancer and ipsilateral lumpectomy/mastectomy with axillary lymph node sampling.
METHODS: Validated volumetric measurements of the limb were obtained presurgery and postsurgery. All complications were recorded. A total of 104 patients enrolled prospectively, and 78 met inclusion criteria with 30 patients in the no tourniquet group and 48 in the tourniquet group. Patients were followed up at 2-week, 6-week, 3-month, 6-month and 12-month intervals. The median number of lymph nodes dissected was 8 (no tourniquet), compared to 7 (tourniquet). Sixty-six percent (no tourniquet) and 58% (tourniquet) had previous radiation. Twenty-eight percent (no tourniquet) and 31% (tourniquet) had previous history of lymphedema. Eight patients (9%) had been previously advised to never have surgery on the involved limb.
RESULTS: There were 3 cases of lymphedema at 2 weeks: 2 patients (no tourniquet) and 1 patient (tourniquet). One patient (no tourniquet) had lymphedema at 2 weeks; only that resolved at 6 weeks. Additional complications include 1 patient (no tourniquet) had pin displacement after distal radius fixation at 2 weeks, 1 patient (tourniquet) had postoperative hematoma after a mass excision, and 1 patient (tourniquet) had hand stiffness following carpal tunnel release. Patient satisfaction between the two groups was high and not statistically different at any time point.
CONCLUSIONS: Surgery in patients with a history of breast cancer with lymph node sampling appears to be equally safe with or without the use of a tourniquet and carries a low rate of overall complications, including exacerbation of their lymphedema.:10.1177/15589447261428585

Development and validation of an interpretable machine learning model integrating inflammatory blood biomarkers for predicting postoperative breast cancer-related lymphedema: A prospective cohort study

Weifeng Cai, Jingyan Feng, Lijuan He, Linying Lin, Liqun Bao, Xiyuan Yang, Zhaodi Lin, Weijing Jiang, Yan Luo, Minyan Chen, Fangmeng Fu, Chuan Wang, Jianqin Fu. Surgery. 2026 Mar 24.

BACKGROUND: Breast cancer-related lymphedema is a frequent and debilitating complication. Early identification of high-risk individuals is critical, yet conventional risk models rarely incorporate systemic inflammatory status.
METHODS: In this prospective cohort, 880 patients undergoing surgery for primary breast cancer were enrolled. Preoperative inflammatory blood biomarkers and clinicopathologic data were collected. A machine learning-based inflammatory model was developed using least absolute shrinkage and selection operator for feature selection and six supervised algorithms for model construction. Independent clinical predictors were identified using multivariable logistic regression, and a combined model integrating inflammatory signature and clinical factors was constructed. Model performance was evaluated in training and test cohorts using discrimination, calibration, and decision curve analysis. Model interpretability was assessed using SHapley Additive exPlanations, and a nomogram was generated for individualized risk calculation.
RESULTS: Overall, 29.0% of patients developed breast cancer-related lymphedema. Fourteen inflammatory biomarkers were selected to construct the signature, and the support vector machine-based inflammatory model demonstrated robust predictive performance (area under the receiver operating characteristic curve: 0.861 in the training set, 0.781 in the test set). Body mass index and lymphadenectomy were identified as independent clinical predictors. The combined model achieved improved discrimination (area under the curve: 0.871 in the training set, 0.811 in the test set), demonstrated favorable calibration and clinical utility. SHapley Additive exPlanations analysis identified platelet × fibrinogen, neutrophil × platelet, derived neutrophil-to-lymphocyte ratio, systemic inflammation response index, and fibrinogen-to-lymphocyte ratio as the most influential features. The nomogram enables individualized risk estimation to guide surveillance and early intervention.
CONCLUSIONS: Integrating systemic inflammatory profiling with clinical variables enables accurate and interpretable prediction of breast cancer-related lymphedema, supporting personalized monitoring and early preventive strategies to reduce postoperative morbidity.:10.1016/j.surg.2026.110146

Assessment

Validity of Ultrasound-Guided Identification of Dilated Lymphatic Vessels to Detect Early Breast Cancer-Related Lymphedema

Akitatsu Hayashi, Takeo Fuziwara. Arch Plast Surg. 2026 Feb 27.-177. Mar

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Outcome Measures to Assess the Effectiveness of Exercise Interventions on Chemotherapy-Induced Peripheral Neuropathy (CIPN): A Scoping Review

Trei R. Lindstrom, Joanna F. Parkinson, Kerry S. Courneya, Margaret (Margie) McNeely. Curr Oncol. 2026 Apr 20.

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Exploring the Role of AI in Managing Treatment Recommendations for Lymphedema: International, Multidisciplinary, Multiprofessional Survey Study of Trust, Reliability, and Impact on Decision-Making

Fabi A, Egli CE, Wendelspiess SR, Griewing S, Haas Y, De Pellegrin L, Schaefer DJ, Qiu SS, Harder Y, Kappos EA. JMIR Med Inform 2026;14:e80553. doi: 10.2196/80553

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Management Strategies

Knowledge and views of lymphoedema health professionals on lymphoedema risk reduction recommendations

Melanie J. Thomas. Br J Nurs. 2026 Apr 2. Epub 2026 Apr 6.

BACKGROUND: Upper limb lymphoedema is a common complication after breast cancer treatment, and lymphoedema risk reduction recommendations (LRRR) are integral to survivorship care. However, little is known about lymphoedema health professionals’ (LHPs) knowledge and practices regarding these recommendations. AIM: To examine LHPs’ knowledge, views and practices on LRRR for breast cancer survivors.

METHODS: A quantitative survey using a bespoke questionnaire was distributed via professional networks and social media. It assessed demographics, knowledge of 26 LRRR, attitudes and perceived barriers. Data were analysed using descriptive statistics, factor analysis, and thematic analysis of free-text responses.

RESULTS: Among 136 UK-based respondents (mainly nurses and physiotherapists), 86% rated LRRR as very important and 88% rated their knowledge highly. Yet only 30% advised all three evidence-based recommendations (weight management, exercise, cellulitis risk reduction). Outdated advice and barriers, such as time constraints and lack of multidisciplinary support, were common.

CONCLUSION: Education and standardisation are urgently needed to ensure accurate, evidence-based LRRR delivery.:10.12968.0563

Efficacy of gradient compression sleeves in preventing postoperative upper extremity lymphoedema after breast cancer surgery.

Liao, Y., Chen, M., Ji, Q., Jin, C., Zhu, X., Xie, L., … Wang, L. (2026).  Expert Review of Medical Devices, 1–11. https://doi.org/10.1080/17434440.2026.2664423

Background

Breast cancer-related lymphedema (BCRL) is a serious complication after breast cancer surgery. This study evaluated the efficacy of gradient compression sleeves in preventing BCRL.

Research design and methods

In this prospective randomized controlled trial, 104 postmastectomy patients were randomized to conventional care (n = 52) or conventional care plus gradient compression sleeves (20–30 mmHg) for 12 months. The primary outcome was arm circumference change at 10 standardized sites measured at 90, 180, and 360 days post-surgery for evaluating efficacy. Secondary outcomes included Breast Cancer Lymphedema Symptom Experience Index (BCLE-SEI) for symptom severity and life impact for evaluating safety. Blinding of participants was not feasible due to the nature of the intervention.

Results

The intervention group showed significantly smaller increases in arm circumference at multiple sites at 180 and 360 days (p < 0.05). BCLE-SEI scores for symptom severity and life impact were significantly lower in the intervention group (p < 0.05). No serious adverse events occurred; eight mild transient skin irritations were reported.

Conclusions

Prophylactic gradient compression sleeves may reduce BCRL progression and improve quality of life. Limitations include single-center design and lack of blinding.

Occupational Therapy in the Treatment of Breast Cancer-Related Lymphedema: A Narrative Review

Ana Belén Jiménez-Jiménez, Irene Elvira-Pastor, Fernando Jesús Mayordomo-Riera, María Nieves Muñoz-Alcaraz. Med Sci (Basel). 2026 Mar 17.

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Effectiveness of physical therapy for lower limb lymphedema in gynecological cancer survivors: a systematic review of randomized controlled trials

Yuancheng Wu, Xinyu Li, Peng Shao, Tao Wang. Front Oncol. 2026 Mar 20.

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The impact of early exercise intervention on the incidence and severity of lymphedema following axillary lymph node dissection in breast cancer

Miaowei Wang, Xia Zhang, Guo Li, Ao Wang, Yuqi Wu, Dae-Keun Jeong. Gland Surg. 2026 Feb 27. 

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Efficacy of physical therapy for prevention and treatment of postoperative lymphedema in breast cancer: a systematic review and meta-analysis

Xiaomin Sun, Yuyu Wei, XiaoXia Zhang, Xinqi Zhuang, Yin-Ping Zhang. Front Oncol. 2026 Mar 25.

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Effects of photobiomodulation therapy on upper limb lymphedema secondary to breast cancer: a systematic review and meta-analysis

Chenjie Qian, Zixin He, Chunhua Liu, Yuan Fang, Yongfei Zheng, Zunjing Zhang, Zhi Ye. Front Oncol. 2026 Mar 23

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Lymphedema Care after Breast Cancer Surgery: Insights from a New Meta-Analysis

Zhong Yan, Fu Jiejie, Song Wenhua, Kong Yilin. Lymphat Res Biol. 2026 Apr 18

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A Systematic Review of Contemporary Randomized Controlled Trials for Treatment of Lower Extremity Lymphedema by Intermittent Pneumatic Compression Devices

Thomas F. O’Donnell, Alexander Tedesco, John Fish. J Vasc Surg Venous Lymphat Disord. 2026 Apr 15

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Effect of a WeChat Intervention Based on the Common-Sense Model on Breast Cancer-Related Lymphedema Preventive Behaviors: Quasi-Experimental Study

Xia Luo, Jing Chen, Mingfang Li, Xinyi Li, Jun Yan. JMIR Form Res. 2026 Apr 24.

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