Hot off the Press August 2026

Article to ponder

This systematic review found that chronic venous insufficiency (CVI) coexists in about half of patients with lower extremity lymphoedema, with a pooled prevalence of 45.7%. Patients with both conditions were more often female and frequently had obesity. Despite considerable variation in study methods and generally low-quality evidence, the findings suggest that venous disease is common in people with lower limb lymphoedema and should be routinely assessed as part of clinical evaluation

Prevalence and Clinical Characteristics of Chronic Venous Insufficiency among Individuals with Lower Extremity Lymphoedema: A Systematic Review and Meta-analysis

Daniel Önefäldt, Sahar Hamdi Ali, Kevin Mani, Ehsan Abualanain, Gustaf Tegler, Maria Mani. Eur J Vasc Endovasc Surg. 2026 Jul 1.

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Key Takeaway: Approximately 1 in 2 patients with lower extremity lymphoedema also have chronic venous insufficiency (CVI), highlighting the importance of routinely assessing both the venous and lymphatic systems when evaluating and managing lower limb swelling

Prevalence and Risk Factors

Determinants In Recurrence Of Lower Limb Cellulitis

RC KV, D Bibiana – Int. J. Sci. R. Tech, 2026

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Does the prophylactic use of compression garments reduce the risk of lower limb lymphedema after pelvic and/or inguinal lymphadenectomy for gynecological cancer? A systematic review

S Gentileschi, G Garganese, SM Fragomen et al – International Journal of Oncological Cancer 2026

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Lymphedema therapy in head & neck cancer with carotid stenosis: a systematic review and care pathway

Aaron Chang, Douglas Jacoby, Alexander Lin, John N. Lukens, Jie Deng, Sarena Banas, Jasmine Zheng, Oral Oncol. 2026 Jun 30.

OBJECTIVE: Head and neck cancer (HNC) survivors treated with radiation therapy are at increased risk for both lymphedema and carotid artery atherosclerosis. The coexistence of these conditions creates complex management challenges, yet no clinical practice guidelines currently address this overlap. This report aims to develop a preliminary clinical care pathway to guide lymphedema treatment in irradiated HNC survivors at risk for carotid atherosclerosis.

METHODS: A comprehensive literature search was conducted in June 2023 and updated in September 2025 using three primary MeSH components: head and neck cancer, lymphedema therapy, and atherosclerosis. Searches were performed across PubMed, Embase, and CINAHL, along with relevant professional organization resources. A multidisciplinary working group-including experts in radiation oncology, preventive cardiology, rehabilitation, and lymphedema management-reviewed the evidence and developed a proposed care pathway.

RESULTS: The search identified 85 unique articles. After title and abstract screening, one article underwent full-text review; however, none directly addressed lymphedema management in irradiated HNC survivors at risk for carotid atherosclerosis. To address this gap, the working group developed a preliminary clinical care pathway based on the available evidence and expert consensus.

CONCLUSION: This pathway represents an initial effort to guide the management of lymphedema in irradiated HNC survivors with coexisting cardiovascular risk. It integrates limited published evidence with multidisciplinary clinical expertise in oncology, cardiovascular risk assessment, and lymphedema care. Further validation and refinement are needed to support clinical implementation.:10.1016/j.oraloncology.2026.108063

Assessment

Can Knowledge and Motivation for Lymphedema Self-Management Be Improved with the Use of ICG Lymphography? A Prospective Observational Repeated Measures Study

M Trevethan, E Doig, F Patterson, A Pigott, Lymphology. 2026.

ICG lymphography is a lymphatic imaging tool that can inform lymphedema treatment, including self-management. Self-management requires patient engagement in a multimodal treatment program. However, lack of knowledge about lymphedema, challenges maintaining motivation, and lack of confidence in ability to perform self-management are barriers to engagement. This study aimed to determine if there was any change (immediate and/or delayed) to patient knowledge, motivation, confidence in lymphedema self-management, or lymphedema distress after undergoing ICG lymphography. A secondary aim was to observe health-related quality of life. A prospective observational repeated measures study followed 25 consecutive participants with limb lymphedema at three timepoints: pre; directly post; and, 12-months post ICG lymphography. A questionnaire exploring knowledge, motivation and confidence in self-management, along with lymphedema distress and a health-related quality of life tool were completed at each timepoint. Patients’ knowledge about lymph-edema improved over all timepoints (p<0.001). Motivation for lymphedema self-management improvements trended toward significance directly post ICG lymphography (p=0.053), but was not maintained at 12-months. No other variables demonstrated significant change. Patients described the experience of undergoing ICG lymphography as positive and reported key learnings and changes to their self-management. ICG lymphography could be a useful tool to improve a person's knowledge of their lymphedema and may positively influence motivation to engage in self-management. Further exploration to sustaining motivation over time and potential im-pacts to lymphedema outcomes is necessary.

The Burden of Breast Cancer-Related Lymphedema on Upper Extremity Functionality: A Comparative Analysis with Healthy Controls and Across Disease Stages

S.C. Gultekin, A.B. Cakir, Z.G. Guc, F.R. Ozalp, M Keskinkilic, T Yavuzsen, D Karadibak. Lymphology. 2026.

The primary study aim compared upper extremity (UE) functionality between breast cancer- related lymphedema (BCRL) patients and healthy controls. A secondary aim compared UE functionality based on lymphedema stage. The study included 50 women with unilateral BCRL and 50 healthy controls. UE functionality was assessed using the following measurement tools: the universal goniometer for range of motion (ROMs), digital inclinometer for proprioception, Semmes-Weinstein monofilament (SWM) test for light touch sensation, Upper Limb Functional Test (ULIFT) score for functionality and mobility, Disability of the Arm, Shoulder and Hand (DASH) for UE disability level, hand grip strength for peripheral muscle strength, and Upper Extremity Lymphedema Quality of Life questionnaire 27 (ULL-27) and Short Form 36-item Health Survey (SF-36) for quality of life (QoL). BCRL patients had reduced UE ROMs, UE functionality and mobility, hand grip strength, worse DASH score, impaired proprioception, light touch sensation and poorer quality of life compared to healthy controls (p<0.05). Significant between-group differences were detected in UE ROMs, ULIFT, DASH outcomes, proprioception, light touch sensation and physical and mental sub-scores of QoL assessments (p<0.05), while no significant differences were detected for hand grip strength, ULL-27 global score (p>0.05) according to lymphedema stage. Findings exhibited that patients with BCRL present with worse UE mobility, increased disability, loss of proprioception, impaired light touch sensation, and lower QoL compared to their healthy controls. UE functions and QoL may also vary between patients according to lymphedema severity.

Lymphatic Ultrasound in Longitudinal Decision-making for Lymphedema: A Narrative Review Integrating Conservative and Surgical Management

Makoto Mihara, Hisako Hara, Yohei Iwanaga. Plast Reconstr Surg Glob Open. 2026 Jul 14.

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Lipedema: Pathophysiology, Functional Limitations and Physical Activity Implications–A Narrative Review

K Karwat, S Gut, J Miarczyński, N Wiercińska… – Quality in Sport, 2026

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1325 GLP-1 Agonists in Lymphedema: A Systematic Review of Clinical Evidence

JJE Wong, R Alderhali, M Jameel, I Seth, F Ruccia… – British Journal of Surgery, 2026

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Management Strategies

Non-Invasive Approaches to Internal Lymphedema in Head and Neck Cancer Survivors: A Scoping Review

Vicki Liu, Jacob Martinez, Helena T. Yip, Steven J. Wang. Head Neck. 2026 Jun 25.

BACKGROUND: Head and neck lymphedema (HNL) is a common sequela of head and neck cancer (HNC) treatment. While external HNL has been increasingly studied, research addressing internal laryngopharyngeal HNL remains limited. This review synthesizes literature on non-invasive interventions targeting internal HNL.
METHODS: A scoping review of PubMed/MEDLINE, Embase, and Scopus through January 2026 was conducted following PRISMA-ScR guidelines.
RESULTS: Of 768 records retrieved, nine studies published between 2020 and 2025 met criteria, reflecting 619 patients. This comprised three randomized clinical trials, three retrospective studies, one prospective trial, one pilot study, and one case report. Approaches included complete decongestive therapy, Kinesio Taping, pneumatic compression, and photobiomodulation, delivered by physical therapists, speech-language pathologists, and physiatrists. Outcomes were variable with inconsistent reductions in internal HNL, despite patient-reported improvements in swallowing.
CONCLUSIONS: Current evidence on non-invasive therapies for internal HNL is heterogeneous and sparse. Despite suggestions of benefit in small-scale studies, further research is necessary to guide clinical integration.:10.1002

Finite Element Modeling of Lower Limb Lymphedema: Influence of Limb Morphology and Compression Garment Classes on Internal Pressure Distribution

Mateus Américo de Almeida, Aratz García-Llona, Maha Reda, Stéphane Avril. Ann Biomed Eng. 2026 Jul 19.

PURPOSE: Compression therapy with medical graduated compression garments is commonly used in the treatment of leg lymphedema. However, the relationship between the interface pressure applied by the garment and the resulting hydrostatic pressure within the soft tissues remains poorly understood. Women commonly use thigh-high garments, whereas men often use knee-high compression garments, but the effects of these different garment types remain unclear. The objective of this study was to evaluate pressure transmission within lymphedematous legs and to assess the effects of different garment types.
METHODS: Patient-specific finite element models were developed from magnetic resonance imaging data of eight female and three male lymphedematous legs. The models explicitly represented the skin, fascia cruris, subcutaneous tissue, and muscle. Interface and hydrostatic pressures were quantified for class 2 and class 3 compression garments, as well as for three garment superimposition configurations.
RESULTS: For all legs wearing class 2 compression garments, and for female legs wearing class 3 compression garments, interface and hydrostatic pressures were below therapeutic ranges. Male legs wearing class 3 compression garments achieved hydrostatic pressure values within the therapeutic range due to higher garment stiffness. Superimposition of garments increased hydrostatic pressure in female legs and led to excessive compression in male legs.
CONCLUSION: These findings highlight the influence of limb morphology and garment mechanical properties on compression therapy. Class 2 or class 3 garments alone may be insufficient for female patients, whereas superimposition should be applied cautiously in male patients. Patient-specific finite element analyses may support more individualized compression therapy prescriptions.:10.1007

Progressive resistance exercise for preventing breast cancer-related lymphedema after breast cancer surgery: A systematic review and meta-analysis

Shufang Chen, Sijing Wu, Yanzhi Chen, Wenting Tan. Biomol Biomed. 2026 Jun 26

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Interventions to improve the psychosocial outcomes of individuals with lymphedema: a systematic review

Sarah Stolker, Shuya Yin, Wendy Auslander. Support Care Cancer. 2026 Jul 3. 

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Effectiveness of Physical Exercise Programs in Reducing Secondary Lymphedema Associated with Breast Cancer: An Overview of Systematic Reviews

Raúl Alberto Aguilera-Eguía, Carlos Zaror, Ruvistay Gutiérrez-Arias, Héctor Fuentes-Barria, Olga Patricia López-Soto, Cherie Flores-Fernández, Miguel Ángel Alarcón-Rivera, Ángel Roco-Videla, Bárbara Búrgos-Mansilla, Constanza Ulloa-López, Víctor Pérez-Galdavini, Luis Arriagada-Pérez, Mariana Melo-Lonconao, Xavier Bonfill, Pamela Seron. J Clin Med. 2026 Jun 26

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Evaluating The Reliability And Readability Of Websites Providing Information On Lymphedema

MS Kılıçoğlu, OV Yurdakul, T Aydın – Rheumatology Quarterly, 2026

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