Hot off the Press November 2026

Article to ponder

This article highlights two potential ways GLP-1 receptor agonists may benefit lymphatic function: weight loss may reduce lymphatic load and inflammation, while experimental evidence suggests semaglutide may directly improve lymphatic vessel pumping. However, human evidence remains limited, and further controlled studies are needed to establish whether these drugs have a direct therapeutic effect on lymphoedema; they should not currently be prescribed specifically for this purpose.

GLP-1 receptor agonists and lymphedema: from weight loss to potential direct modulation of lymphatic function

Eva Klara Merzel Šabović, Miodrag Janić, Tanja Planinšek Ručigaj. Front Endocrinol (Lausanne). 2026 Oct 8. 

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Key Takeaway: GLP-1 receptor agonists show potential to improve lymphatic function, but their therapeutic benefit for lymphoedema in humans remains unproven.

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

A dermal backflow atlas of lymphatic dysfunction in breast cancer-related lymphedema with machine learning-based stage prediction

Lalida Sutejitsiri, Hiroo Suami, Poul M. F. Nielsen, Anthony R. J. Phillips, Hayley M. Reynolds. Breast Cancer Res Treat. 2026 Oct 7.

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Prevalence and Risk Factors

Risk factors for post-traumatic lymphedema after open fractures of the lower leg: a retrospective cohort study

Xiao Huang, Yuji Zhang, Zhenkun Lv, Zhijin Liu, Shuai Dong, Ruowen Zhou, Wen Ju, Jihui Ju, Ruixing Hou.Front Surg. 2026 Sep 11.

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Analysis of Risk Factors for Progression of Breast Cancer-Related Lymphedema from the Reversible to Irreversible Stage: A Single-Center Retrospective Case-Control Study

Zebing Luo, Manjia Xu, Weijie Gao, Qiongshan Chen, Zhijun Guo, Shuxian Yu. Int J Womens Health. 2026 Sep 26

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Risk Factors for Persistent Lymphedema Following Modified Axillary Lymph Node Dissection in Breast Cancer Patients: A Retrospective Single-Center Study

Iraj Feizi, Bahareh Nikandam, Zohreh Shahabi, Amir Ahmad Arabzadeh. Int J Breast Cancer. 2026 Sep 28

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Effect of BMI-stratified management based on the meridian-lymph axis theory on lower extremity lymphedema after gynecological cancer surgery: a randomized controlled trial

Yulin Geng, Hong Zhang. Front Oncol. 2026 Sep 24

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Artificial Intelligence for Prediction of Breast Cancer-Related Lymphedema: A Systematic Review

Hatan Mortada, Mustafa Qais Muhsin Al-Khafaji, Zainalabden E. Jefri, Faris Sultan, Saad Alrobaiea, Feras Alshomer. Plast Reconstr Surg Glob Open. 2026 Oct 6. Oct.

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Health literacy as a determinant of psychosocial and functional outcomes in individuals at risk for lymphedema

Sefa Gümrük Aslan, H. Anıl İnan, Sinem Uyar Köylü, Sibel Mandıroğlu. Support Care Cancer. 2026 Oct 22

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Risk Factors for Lymphedema After Breast Cancer Surgery: A Prospective Cohort Study Evaluating Axillary Surgical Approaches

Bartu Cetin, Berk Goktepe, Safa Vatansever, Levent Yeniay. Ann Ital Chir. 2026 Oct 14.-1863.

AIM: Breast cancer-related lymphedema remains a major complication that follows axillary surgery. This prospective study evaluated the effects of axillary surgical techniques and treatment-related factors on the development of lymphedema in patients undergoing breast cancer surgery.
METHODS: This prospective observational cohort study included 119 patients who underwent breast and axillary surgery for invasive breast cancer between June 2020 and April 2022. Arm volume measurements were recorded preoperatively and during follow-up at 10-15 days, 1-3 months, 6 months, and 1 year postoperatively using a standardized circumferential method. Lymphedema was defined as a ≥10% increase in the volume difference between the operated and contralateral arm relative to the individual baseline inter-arm difference. Demographic, clinical, and treatment-related variables, including the axillary surgical procedure, radiotherapy, chemotherapy, body mass index, and number of removed lymph nodes, were analyzed. Univariate and multivariable logistic regression analyses were performed to identify potential risk factors associated with lymphedema development.
RESULTS: Lymphedema developed in 18 (15.1%) of 119 patients. The incidence of lymphedema was significantly higher in patients who underwent axillary lymph node dissection (ALND; 24.4%) than in those who underwent sentinel lymph node biopsy (SLNB; 10.3%, p = 0.040). No significant association was observed between axillary radiotherapy and lymphedema development (p = 0.809). No variables remained statistically significant after multivariable adjustment. However, ALND showed a trend toward an increased risk of lymphedema (odds ratio [OR] 6.14, 95% confidence interval [CI] 0.91-41.49, p = 0.063), whereas neoadjuvant chemotherapy (NACT) showed a trend toward a reduced risk (OR 0.34, 95% CI 0.10-1.19, p = 0.091).
CONCLUSIONS: In univariable analyses, ALND was associated with a higher occurrence of lymphedema following breast cancer surgery. However, no variable remained statistically significant after multivariable adjustment, likely reflecting the limited number of lymphedema events and the resulting limited statistical power. In this cohort, NACT was not associated with an increased risk of lymphedema. Although exploratory subgroup analyses suggested a lower incidence of lymphedema among patients undergoing SLNB following NACT, these findings should be interpreted cautiously given the limited subgroup size and require confirmation in larger prospective studies. These findings support ongoing efforts to minimize unnecessary axillary dissection whenever oncologically appropriate.:10.62713

Venous interventions reduce the risk of lymphedema in chronic venous insufficiency

John Yuxuan Ha, Berk B. Ozmen, Douglas Joseph, Scott Cameron, Jennifer Murphy, Graham Schwarz. Vasc Med. 2026 Oct 17.X261472418.

INTRODUCTION: Chronic venous insufficiency (CVI) significantly increases the risk of developing secondary lymphedema and related infections. This study tested the hypothesis that lower-extremity venous procedures can reduce the 5-year incidence of lymphedema in adults with CVI.
METHODS: A multicenter retrospective cohort study was conducted using the TriNetX Research Network. Adults (⩾ 18 years) diagnosed with CVI between Jan 1, 2005, and Jan 1, 2020, were identified and followed for at least 5 years. Patients were stratified into those undergoing venous procedures, including saphenous vein ligation, phlebectomy, sclerotherapy, and endovenous ablation, and matched controls managed without intervention. Propensity score matching was performed 1:1 on demographics, comorbidities, and infection-related variables. The primary outcome was new-onset lymphedema, assessed using Cox proportional hazards models and Kaplan-Meier analysis.
RESULTS: After matching, 17,703 patients were included in each cohort. At 5 years, new-onset lymphedema occurred in 5.1% of controls versus 4.0% of patients who underwent venous procedures (hazard ratio [HR] 1.26, 95% CI 1.14-1.40). Phlebectomy showed the strongest association with risk reduction (4.0% vs 1.5%; HR 2.60, 95% CI 1.33-5.06), followed by varicose vein sclerotherapy (5.3% vs 3.6%; HR 1.49, 95% CI 1.02-2.16).
CONCLUSIONS: Venous interventions may reduce the risk of developing lymphedema in patients with chronic venous insufficiency.:10.1177/1358863X261472418

Chronic Lower Limb Edema in People with Multiple Sclerosis: Prevalence, Cause and Impact

Vaughan L. Keeley, Lorraine Pinnington, Katie Riches, Michael Jones, Apostolos Fakis, Margaret Phillips, Christine Moffatt. Lymphat Res Biol. 2026 Oct 19.

BACKGROUND: Chronic lower limb edema (CLLE) is a feature of advanced multiple sclerosis (MS) but its prevalence and causative factors are not clearly established. The aims of the study were to determine the prevalence and possible causative factors of CLLE in people with MS, and to examine the impact of CLLE on participants’ quality of life.

METHODS AND RESULTS: The prevalence of CLLE was determined by questionnaire (i.e., self-reported) and by clinical examination. Possible causative factors were recorded including level of disability using Expanded Disability Status Scale (EDSS) and the impact on participants’ quality of life was assessed using LYMQOL. The self-reported prevalence of CLLE was 42.4% (101/238). The prevalence determined by clinical assessment was 61.9% (99/160). Possible causative factors were shown to include age, reduced mobility, and vasomotor autonomic dysfunction. In the multivariate analysis, only EDSS was statistically significant (p = 0.002) with an incidence rate ratio (sd) of 2.1 (0.52). In those with CLLE, scores in the function, appearance, and symptom domains of LYMQOL demonstrated a poorer quality of life. There was a higher incidence of cellulitis in those with CLLE (14% compared with 2%).

CONCLUSIONS: CLLE is a common problem is people with MS but may not always be recognized by patients. It can impact a person’s quality of life and poses a risk of cellulitis. Improved recognition and treatment of CLLE should improve the quality of life of people with MS.:10.1177/15578585261496094

Assessment

Lymphedema Adaptive Clothing Exploration: A Scoping Review of Clothing Challenges for People Living with Lymphedema

Elizabeth A. Anderson, Naomi D. Dolgoy, Kerri McBee-Black. Lymphat Res Biol. 2026 Sep 21.

BACKGROUND: Lymphedema consists of swelling that impedes movement and compromises quality of life. It is estimated that 250 million people worldwide have a diagnosis of lymphedema. People living with lymphedema often have difficulty sourcing everyday clothing that fits over compression garments and swollen limbs. A scoping review was conducted to gain deeper insight into the current state of the literature addressing lymphedema-specific clothing issues and identifying knowledge gaps.

METHODS AND RESULTS: The five-stage Arksey and O’Malley framework guided the review process. Five electronic databases (PubMed, CINAHL, Scopus, Web of Science, and PsycINFO) were searched for articles written in English from 2004 to 2024. Ten studies addressing lymphedema clothing issues were included in the analysis. Articles varied widely across disciplines, publication dates, and journals. Common themes of clothing function challenges, aesthetic considerations, social/cultural stigma related to clothing, and textile development (sensors) were identified. Children and women were noted to have significant issues sourcing aesthetically acceptable footwear and are often impacted by cultural stigma. Activity restriction (e.g., ill-fitting clothing) negatively impacted the quality of life. Self-esteem can be compromised by social stigma from a swollen limb and inability to wear appropriate clothing. Uniqueness of human anatomy and presenting lymphedema symptoms challenges the development of effective textile sensors.

CONCLUSIONS: The dearth of available literature (10 studies) highlights the critical need to address clothing issues in this population through collaborative research initiatives. Preferences and needs should be solicited and thoughtfully integrated into the development of lymphedema-appropriate clothing to maximize the quality of life and support lymphedema self-management.:10.1177/15578585261486340

Exploring barriers and enablers to cultural competency in lymphoedema services: a survey-based service evaluation

Garry Cooper, Marie E. Gabe-Walters, David Florentin, Karen Morgan, Melanie J. Thomas. Br J Nurs. 2026 Oct 8.

BACKGROUND: Lymphoedema is a chronic condition that impairs mobility, causes pain and reduces quality of life. People from ethnic minority backgrounds appear under-represented in lymphoedema services in Wales, reflecting broader health inequalities across the UK.

PURPOSE: This service evaluation explored barriers and enablers to providing culturally competent lymphoedema care, as reported by health professionals.

METHODS: An anonymous online survey was distributed to lymphoedema practitioners across the UK. The survey combined self-rating scales of cultural awareness, knowledge and skills with open-text questions. Quantitative data were analysed descriptively, and qualitative responses were examined thematically.

CONCLUSIONS: Fifty-eight practitioners responded. Most rated their cultural awareness, knowledge and skills above the neutral point, indicating confidence in these areas. However, free-text responses highlighted persistent challenges, including limited time, inconsistent access to training and a lack of culturally inclusive resources.

IMPLICATIONS FOR PRACTICE: Targeted workforce development, co-produced educational materials and inclusive communication strategies can support lymphoedema nurses to deliver more equitable, culturally responsive care across the UK.:10.12968.0494

Lymphoedema in Head and Neck Cancer Survivors: Healthcare Professionals’ Perspectives

Kadriye Yusra Sert, Purnima Sundaresan, Emma Charters, Rebecca Venchiarutti, Chindhu Shunmuga Sundaram, Melissa Thorne, Haryana M. Dhillon. Head Neck. 2026 Oct 23.

INTRODUCTION: Improvements in head and neck cancer (HNC) treatment have increased survival rates, resulting in survivors living with side effects, such as head and neck lymphoedema (HNL). We aimed to document healthcare professionals’ perceptions of HNL, approaches to managing HNL, and integration of HNL management into routine practice in Australia and New Zealand.
METHODS: We conducted an online, 51-item survey between February and October 2024. The survey comprised two main sections: (i) all healthcare professionals working with HNC and HNL; and (ii) only HNL therapists.
RESULTS: Participants included in the analysis of the (i) HNC healthcare professionals section (n = 73/113), and (ii) HNL therapists section (n = 40/46). 45% (n = 33/73) of the participants reported not having access to a specialized multidisciplinary team for HNL management. 55% (n = 22/40) of HNL therapists reported not having standardized institutional lymphoedema management protocols.
CONCLUSIONS: Findings highlight the need for system-level guidelines, clearer pathways, improved education resources, and coordinated MDTs to improve HNL management.:10.1002

Effect of Supine Versus Sitting Positions on Facial Tissue Dielectric Constant Values in Young Adult Men

Harvey N. Mayrovitz. Cureus. 2026 Aug 28

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Assessment and Management of Extremity Lymphedema: Position Paper of WSRM

Peter Neligan, Dimitrios Dionyssiou, David Woosuk Chang, Jaume Masia Ayala, Akitatsu Hayashi, Johnson Chia-Shen Yang, Dhruv Singhal, Joon Pio Hong. J Reconstr Microsurg. 2026 Sep 28.

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Exploring the aesthetic and sexual health impacts of reported lower extremity lymphedema-related symptoms in 174 patients following inguinal lymphadenectomy

Brett A. Hahn, Alieske Kleeven, Milan C. Richir, Arjen J. Witkamp, Anke M. J. Kuijpers, Kristien B. M. I. Keymeulen, J. Henk Coert, Shan Shan Qiu, David D. Krijgh. JPRAS Open. 2026 Sep 12.-414. Nov.

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Current status of lymphedema-related health information-seeking behavior and its associated factors among postoperative breast cancer patients: a cross-sectional study

Huan Zheng, Fang Chen, Lu Wang, Kai Cao, Xiaoyan Zhao, Lewen Shao. Support Care Cancer. 2026 Oct 12

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Management Strategies

Impact of climatic variations on lymphoedema: an international comparison

Susan Witt, Michael Oberlin, Sue Gordon, Narelle Campbell, Neil B. Piller. Br J Community Nurs. 2026 Sep 22.

BACKGROUND: Lymphoedema is a chronic condition that requires ongoing, daily management. It can have a significant impact on an individual’s quality of life and comes with a high personal and health service cost. Lymphoedema is a highly dynamic disease requiring constant adaptation of management techniques to prevent worsening of the symptoms.

AIMS: To understand differences in lymphoedema management across the changing seasons in Germany and Australia. METHODS: Focus groups were conducted in Germany with people living with lymphoedema by following a phenomenological approach. Outcomes were compared to those from focus groups previously conducted with people in Australia.

FINDINGS: There were high similarities between countries, with most participants reporting that heat and humidity caused increased challenges in managing lymphoedema, namely that the affected limb felt heavier, more swollen and caused increased lethargy. European participants tended to do more self-bandaging and more regular therapy appointments than their Australian counterparts.

CONCLUSIONS: All participants reported needing to consider the weather in planning their daily activities, with a large range of strategies implemented to keep their swelling in check and prevent further decline.

IMPLICATIONS FOR PRACTICE: Further research in this area will subsequently contribute to treatment recommendations and may benefit production of new materials that can, in the light of predicted climate change, prepare for the future.:10.12968.0048

Intermittent Pneumatic Compression in Patients with Postmastectomy Lymphedema: A Randomized Controlled Trial

F Newaz, S.M. Ahmed, M.I. Hasan, M.S. Rahman, A.N.M. Nur. Mymensingh Med J. 2026 Oct 35.-1224.

Lymphedema as a result of curative surgery for breast cancer can lead to long term morbidity. Lymphedema following post-radical mastectomy causes family and social problem of young individual. Manual-lymphatic-drainage (MLD), IPC (Intermittent pneumatic Compression), MLB (Multi-layered-bandage) and compression sleeves are main treatment stream along with medication and modification of Activities of Daily Living (ADL). The aim of this study was to evaluate the effects of intermittent pneumatic compression (IPC) alone or in combination with exercises on upper limbs circumference and hand function. Subjects were required to have mild to moderate unilateral upper limb lymphedema acquired as a result of curative cancer surgery. The study population consisted of 21 patients with breast cancer-related lymphedema. One group received IPC for 45 minutes per session at 50-60mmHg, 5 sessions per week for 3 weeks (15 sessions in total), combined with physical exercise, and the other group received physical exercise only. Before and after arm circumference measurement done at six sites on affected limb. Hand function was assessed at six months with the DASH (Disabilities of Arm Shoulder and Hand) clinical questionnaire. Both groups exhibited a reduction in upper limb circumferences after the therapy in comparison to the initial values. The reduction reached statistical significance at most measurement levels in the group that received combined IPC and exercise. Intermittent pneumatic compression is an effective method of reducing post-mastectomy lymphedema. The exercises did not have a significant effect on function of hand.

Efficacy of Inelastic Compression Devices with a High Stiffness in Older Breast Cancer Survivors with Moderate and Severe Lymphedema: A Prospective Interventional Study

Katarzyna Ochałek, Ewelina Matusik, Zbigniew Szygula. J Clin Med. 2026 Sep 20

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Effectiveness of Home-Based Progressive Resistance Exercise in the Management of Breast Cancer-Related Lymphedema: A Randomized Controlled Trial

Suzan Aydın, Sevinj Rafili, Ömer Şevgin. J Clin Med. 2026 Sep 13

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Establishing a Comprehensive Lymphedema Program in a Rural Region

Devin John Clegg, Catherine Lock, Andrew J. Ward, Payton Grande, Ashton J. Brooks, Patricia Ne Roberson, Jillian M. Lloyd, Stefanos Boukovalas. J Reconstr Microsurg. 2026 Oct 5

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Lymphedema Management in May-Thurner Syndrome: A Case Series of 26 Patients

Sabrina Valentina Lazar, Elizabeth Tadevosyan, Nitya Devisetti, Subin Cho, Sirish Kishore, Carrie Kubiak, Dung Hoang Nguyen. J Clin Med. 2026 Sep 28.

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