Hot of the Press September 2025

Article to ponder

A patient-specific 3D computational model was developed to investigate interstitial fluid dynamics in the lower limb under normal, edematous, and lymphedematous conditions, and to assess the impact of compression therapy. The simulations showed that elevated capillary pressure and lymphatic obstruction substantially increased interstitial fluid pressure and limb volume. Compression therapy redistributed fluid, reduced swelling, and counteracted gravity-driven pooling, particularly at the ankle, although its effectiveness was influenced by tissue compliance and the presence of functional lymphatic drainage.

Patient-specific numerical simulation of compression therapy effects on interstitial fluid motion in lower limb lymphedema

Maha Reda, Stéphane Avril. Biomech Model Mechanobiol. 2025 Aug 5. 

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Key Takeaway: Compression therapy reduces swelling and redistributes fluid in lower limb lymphedema, but its effectiveness depends on functional lymphatic drainage and patient-specific tissue characteristics.

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

ICG Lymphography Confirms the Presence of an Alternative Lymph Drainage Pathway Following Long-Term Manual Therapy: A Case for Preserving Traditional MLD Approaches

Mary Wakefield, Jan Douglass, Diane Lacey, Neil B. Piller, Linda C. Blanchfield. Reports (MDPI). 2025 May 6

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Characteristics and advances in signaling pathways, cellular communication, cell junctions, and oxidative stress in lymphedema

Qiancheng Zhao, Zhipu Niu, Ying Pan, Yongqi Hao, Yuan Ma, Jiankai Zhao, Jianshi Du, Yiming Yang. Front Cell Dev Biol. 2025 Jul 22

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Lymphedema pathogenesis involves antigen-driven expansion of CD4+ T cells in skin

Adana-Christine Campbell, Annica R. Stull-Lane, Jung Eun Baik, Ananta Sarker, Jinyeon Shin, Gopika Ashokan, Hyeung Ju Park, Bracha L. Pollack, Pradhi Pakkerakari, Yollanda Franco Parisotto, Arielle Roberts, Chrysothemis C. Brown, Babak J. Mehrara, Raghu P. Kataru. Front Immunol. 2025 Aug 1.

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Comparative analysis of superficial collecting lymph vessels in normal tissue and lymphedema using video-capillaroscopy

Chihiro Matsui, Reiko Tsukuura, Toko Miyazaki, Shigeki Ishibashi, Takakuni Tanaka, Takayoshi Nishimura, Go Arai, Joseph M. Escandón, Hatan Mortada, Takumi Yamamoto. Microvasc Res. 2025 Aug 5:104842.

INTRODUCTION: Lymphedema is a chronic, progressive disorder characterized by impaired lymphatic transport, tissue swelling, and fibrosis. This study used video-capillaroscopy, a high-resolution imaging technique, to assess superficial collecting lymphatic vessels and their vasa vasorum in patients with lymphedema. By comparing these microvascular structures to those in healthy tissue, we aimed to identify early vascular changes contributing to disease progression.
METHODS: VC recordings were retrospectively analyzed from 28 limbs in 17 patients with lower extremity lymphedema and 53 lymphatic vessels in 12 cancer patients undergoing reconstructive surgery. In the latter group, observations were performed on normal subcutaneous tissue exposed at the donor site during flap harvest. These areas showed no tumor involvement, regional metastasis, or prior chemotherapy/radiotherapy. Thus, all normal tissue observations were made on untreated, unaffected sites. VCLs were classified into six stages (0-5) based on morphology and flow. Vessel diameter and red blood cell (RBC) velocity were measured. Statistical significance was set at p < 0.05.
RESULTS: In normal donor tissue, mean VCL main vessel diameter and RBC velocity were 0.038 ± 0.031 mm and 185 ± 160.5 μm/s. In lymphedema, these values were reduced to 0.033 ± 0.024 mm and 28.3 ± 36.8 μm/s (p < 0.001). VCL Stage 0 showed preserved flow (p = 0.178), while Stages 1-5 exhibited progressive impairment.
CONCLUSION: These findings suggest that early ischemic changes in the vasa vasorum may precede lymphatic dysfunction and fibrosis in lymphedema. Preserving microvascular integrity should be a therapeutic focus, alongside drainage support. Further studies are needed to clarify clinical relevance and optimize treatment strategies.:10.1016/j.mvr.2025.104842

Prevalence and Risk Factors

Saturated fatty acids induce lipotoxicity in lymphatic endothelial cells contributing to secondary lymphedema development

Karina P. Gomes, Jacob Korodimas, Emily Liu, Nirav Patel, Xiaoyan Yang, Susan Goruk, Jaqueline Munhoz, Catherine J. Field, Spencer B. Gibson. EMBO Mol Med. 2025 Aug 4

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Lymphedema and Axillary-Lateral Thoracic Vessel Juncture Irradiation: A Clinical Dilemma

Şükran Şenyürek, Merve Duman, Sena Birsen Güçlü, Nilüfer Kılıç Durankuş, Duygu Sezen, Yasemin Bölükbaşı. Eur J Breast Health. 2025 Aug 4.

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A narrative inquiry of men’s perceptions of support and masculinity: semi-structured interviews of men living with non-cancer-related lymphoedema in the United Kingdom

Garry Cooper, Nicola Gale, Manbinder Sidhu, Kerry Allen. J Res Nurs. 2025 Aug 15

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Impact of lymph node staging techniques on lymphedema and quality of life in early-stage endometrial cancer: A prospective cohort study

Anna Torrent, Joana Amengual, Angela Ruiz, Aina Serra, Laura Fuertes, Catalina Maria Sampol, Mario Ruiz, Jorge Rioja, Pilar Roca, Octavi Cordoba. Gynecol Oncol Rep. 2025 Aug 4. Aug.

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Physical exercise and breast cancer-related lymphedema: an umbrella review, systematic review and meta-analysis

Celia García-Chico, Susana López-Ortiz, José Pinto-Fraga, Claudia Ceci, Pedro L. Valenzuela, Saúl Peñín-Grandes, Sergio Maroto-Izquierdo, Grazia Graziani, Carmen Fiuza-Luces, Simone Lista, Alejandro Lucia, Alejandro Santos-Lozano. Disabil Rehabil. 2025 Jul 31.-17.

PURPOSE: The present study aimed to summarize the current evidence on the impact of exercise in patients at risk or with breast cancer-related lymphedema (BCRL) through an umbrella review of existing meta-analysis and a systematic review and meta-analysis of randomized controlled trials (RCTs).
MATERIAL AND METHODS: A search was conducted in PubMed and Web of Science up to June 2025 to identify meta-analyses and RCTs that included exercise interventions in patients at risk or with BCRL.
RESULTS: Three systematic reviews including 14 individual meta-analyses were included in the umbrella review. Two of these met the criteria of strong evidence, reporting beneficial effects of exercise on upper- and lower-body strength. A total of 46 RCTs were included in the systematic review, of which 11 could be meta-analyzed. Strong evidence was found for a beneficial effect of exercise on upper- and lower-body strength and upper-limb disability.
CONCLUSION: Strong evidence supports the beneficial effects of exercise on upper- and lower-body strength and upper-limb disability in patients at risk or with BCRL.:10.1080/09638288.2025.2536722

Factors affecting the formation of lymphedema due to breast cancer (Is primary systemic treatment an independent factor in the formation of breast cancer related lymphedema?)

Melek Kumcuoğlu, Semra Günay, Berk Gökçek. Turk J Surg. 2025 Aug 11.

OBJECTIVE: This study aimed to evaluate the local and systemic risk factors associated with breast cancer-related lymphedema (BCRL), with a focus on whether primary systemic treatment (PST), particularly taxane-based chemotherapy, is an independent risk factor.
MATERIAL AND METHODS: A prospective clinical study was conducted on 80 breast cancer patients discussed at our institution’s weekly breast cancer council. Patients were grouped based on PST status. Clinical examinations and measurements were performed preoperatively and postoperatively at 1, 6, 12, 18, and 24 months. Only the operated arm was assessed using tape measurements and the truncated cone formula. Arm volumes were calculated, and lymphedema (LE) was diagnosed based on a volume difference (≥200 mL or ≥2 cm circumference).
RESULTS: No statistically significant differences were found between PST and non-PST groups regarding age, body mass index, menopausal status, smoking, or tumor characteristics. LE was detected in 7 (8.8%) patients, all Stage 1. PST and taxane-based chemotherapy were not significantly associated with LE development. However, seroma presence (p=0.038) and axillary radiotherapy (p=0.043) were significantly associated with LE. Arm volume increase was most significant at 1 and 18 months postoperatively (p=0.055 and p=0.044, respectively).
CONCLUSION: PST, including taxane-based chemotherapy, does not appear to be an independent risk factor for BCRL. In contrast, postoperative seroma and axillary radiotherapy are significantly associated with LE development. Early identification and management strategies should target these modifiable factors to reduce the risk of LE.:10.47717.

Effects of Resistance Training at Different Intensities on Preventing Breast Cancer-Related Lymphedema: A 1-Year Randomized Controlled Trial

Yi-Jing Fan, Hui-Qian Xu, Hong Li, Zi-Rui Zhang, Shu-Fang Zhang, Ai-Jun Du, Li-Zhi Zhou, Yang Wang. Clin Breast Cancer. 2025 Jul 1.

BACKGROUND: Breast cancer-related lymphedema (BCRL) is a relatively common and harmful complication after breast cancer surgery, and there is currently no effective cure. We hypothesized that, compared with the control group, 12 weeks of resistance exercise at different intensities could reduce the incidence of BCRL after axillary lymph node dissection.
METHODS: 114 breast cancer patients undergoing axillary lymph node dissection were randomly divided into a Control Group (CG), a Low-to-Moderate Intensity Exercise Group (L-MIEG, 40%-70% 1-RM) and a Moderate-to-High Intensity Exercise Group (M-HIEG, 60%-85% 1-RM).
RESULTS: (1) The 12-month cumulative BCRL incidence was higher in the CG (16.3%, 6/37) than in the L-MIEG (8.3%, 3/36) and M-HIEG (5.5%, 2/37). (2) Postintervention and at 6-and 12- month follow-ups, both intervention groups had smaller interlimb differences than the CG (P < .05), and the M-HIEG had smaller differences at 6-month than the L-MIEG (P < .05). (3) InBody analysis showed both intervention groups outperformed CG in segmental water differences, extracellular water (ECW), and single-frequency bioelectrical impedance analysis (SFBIA) (P < .05), and the M-HIEG was better at 6-month (P < .05). (4) At 6-and 12-month follow-ups, both intervention groups improved grip strength more than CG (P < .05), and the M-HIEG was superior at 12 months (P < .05).
CONCLUSIONS: Different- intensity resistance exercises benefit BCRL prevention, with M-HIEG being more effective.:10.1016/j.clbc.2025.07.012

Development and validation of a risk prediction model for lower limb lymphedema in postoperative cervical cancer patients

Zhiyue Li, Ping Wang, Dan Lu, Zhiyun Ding. Int J Gynaecol Obstet. 2025 Jul 30.

OBJECTIVE: Lower limb lymphedema (LLL) is a common postoperative complication in patients with cervical cancer. Here, we analyzed the independent risk factors of LLL and constructed a nomogram prediction model for the early detection of LLL in postoperative cervical cancer patients.
METHODS: A cross-sectional study was conducted at a tertiary hospital in China between January 2020 and December 2023. A univariate analysis was carried out to determine the risk factors possibly related to LLL, and a logistic regression analysis was utilized to determine the independent risk factors related to LLL. Area under the receiver-operating characteristic curve (AUC) calibration plots and decision curve analysis were used to assess the performance of the nomogram model.
RESULTS: Independent predictors for LLL risk included body mass index, hypertension, urinary tract infection, number of lymph nodes dissected, radiotherapy, chemotherapy, and functional exercise frequency. The clinical prediction model was established based on the above seven risk factors and showed superior predictive power both in the training cohort (AUC = 0.861) and the validation cohort (AUC = 0.837). The nomogram was well-calibrated. The decision curve analysis demonstrated that the LLL risk nomogram was clinically applicable.
CONCLUSION: The model has good discrimination and accuracy for LLL risk assessment, which can provide a reference for individualized clinical prediction of the risk of LLL in postoperative cervical cancer patients. Multicenter prospective trials are required to verify the predictive value of the model.:10.1002

The Effect of Vitamin D Levels on Breast Cancer-Related Lymphedema

G.D. Karakilic, M.A. Selcuk. Lymphology. 2025.

The purpose of this study was to compare plasma vitamin D levels in patients with breast cancer-related lymphedema (BCRL), breast cancer (BC) without lymphedema, and healthy populations, as well as relationship between clinical variables, lymphedema severity grading, and circulating vitamin D concentrations. This Case-control study was conducted between June 2017 and January 2025. The study comprised three cohorts: a case cohort of individuals diagnosed with breast cancer-related lymphedema (BCRL), a disease-matched control cohort of breast cancer (BC) patients without lymphedema (demographically aligned with the BCRL cohort by age and sex), and a reference cohort of healthy participants matched by age and sex. A total of 603 female individuals were included in the study with 201 individuals in each group. Post-hoc Games-Howell test analyses revealed a lower level of Vitamin D in the BCRL group compared to the BC and control groups (p<0.001, p<0.001) and lower levels in the BC group compared to the control group (p<0.001). Vitamin D deficiency was statistically significantly more frequent in BCRL group than in BC and control groups (p:<0.001) and the proportion of those with normal vitamin D were statistically significantly more frequent in control group than in BCRL and BC and control groups (p:<0.001). Analysis revealed a strong, significant negative correlation between circulating vitamin D concentrations and advancing lymphedema stage (r: -0.578, p:<0.001). These observations imply that hypovitaminosis D may contribute to breast cancer pathogenesis and modulate the risk of treatment-associated morbidities, particularly lymphedema progression. Therefore, it is recommended that individuals diagnosed with BC or at risk of lymphedema have their vitamin D levels checked regularly and take supplements if necessary.

Assessment

The Importance of a Pre-treatment Baseline When Screening Patients for Breast-Cancer-Related Lymphedema

Steven L. Chen, Chirag Shah, John Boyages, Louise Koelmeyer, Frank A. Vicini, Sheila H. Ridner. Ann Surg Oncol. 2025 Jul 23.

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At-Home Bioelectrical Impedance Analysis (BIA) Monitoring of Adult Females at Risk of Breast Cancer-Related Lymphedema: Nonrandomized One-Year Longitudinal Feasibility Study

Cheri Teranishi-Hashimoto, Monica Padilla, Yoomi Heo, Lori Bravi. JMIR Form Res. 2025 Jul 24

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Psychosocial Impact of Postmastectomy Lymphedema Syndrome: Insights From a National Claims Database Analysis of Antidepressant Prescription Fills

Daniel Najafali, Jennifer K. Shah, Thomas M. Johnstone, Justin M. Camacho, Priscila C. Cevallos, Kometh Thawanyarat, Yelissa Navarro, Rahim S. Nazerali, Clifford C. Sheckter. Plast Reconstr Surg Glob Open. 2025 Aug 5. Aug

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Assessing Head and Neck Cancer-Related Lymphoedema Using Indocyanine Green Lymphography-A Pilot Study

Katrina Gaitatzis, Belinda Thompson, Hiroo Suami, Fiona Tisdall Blake, Asha Heydon-White, Puma Sundaresan, Dion Forstner, Louise Koelmeyer. Head Neck. 2025 Jul 24.

BACKGROUND: Head and neck cancer treatments can cause head and neck lymphoedema (HNL), impacting quality of life (QoL). This study examined lymphatic drainage changes in HNL using Indocyanine Green Lymphography (ICG-L) and assessed QoL, physical, and functional outcomes.
METHODS: Twenty individuals with HNL and 10 healthy controls completed the Lymphedema Symptom Intensity and Distress survey, bioimpedance spectroscopy (BIS), skin assessments, percent water content, and ICG-L. Analysis included non-parametric and Kruskal-Wallis tests.
RESULTS: ICG-L showed preserved original lymphatic drainage in non-surgical and unilaterally treated individuals, while bilateral treatment disrupted original pathways, prompting compensatory drainage. Individuals with HNL reported significantly higher scores in soft tissue sensation, neurological symptoms, and biobehavioral symptoms (p < 0.001). Skin assessments revealed swelling and fibrosis. Significant differences were observed in lymphatic dysfunction (p = 0.002), BIS-derived skeletal muscle mass percent (p = 0.015), and phase angle (p = 0.002).
CONCLUSIONS: This study highlights the symptom burden and altered lymphatic drainage in HNL, with ICG-L showing potential for refining management strategies.:10.1002

Examining the Interrelationships of Lymphedema with Pain, Physical Function, and Demographic and Medical Variables in Women with Breast Cancer and Pain

Grace H. Amaden, Kelly A. Hyland, Joseph G. Winger, Sarah A. Kelleher, Allison K. Diachina, Shannon N. Miller, Kelly Westbrook, Gretchen Kimmick, Linda Sutton, Mei R. Fu, Tamara J. Somers. Clin Breast Cancer. 2025 Jul.

PURPOSE: To examine the relationship of lymphedema with pain, physical function, and demographic and medical variables in women with breast cancer and pain.
METHODS: Secondary analysis of baseline data from a study of women with breast cancer and pain. Self-report questionnaires assessed lymphedema, pain severity, pain medication use behavior, pain-related cognitions (ie, pain self-efficacy, pain catastrophizing), and physical function (ie, basic and intermediate activities of daily living (ADLs)). Demographic and medical variables were extracted from the medical record. Univariate analyses examined relationships among lymphedema and variables of interest.
RESULTS: Women (N = 347, Mage = 57 years, 63% White) reported moderate pain severity (M = 4.04). Twenty-six percent of women (n = 85) reported having lymphedema. Women with lymphedema endorsed greater pain severity (P = .007) and pain catastrophizing (P = .015) than women without lymphedema; groups did not differ on pain medication use or pain self-efficacy. Women with lymphedema reported a reduced capacity to complete intermediate ADLs compared to women without lymphedema (P = .044); groups did not differ on ability to complete basic ADLs. Women with lymphedema were more likely to be non-White, have lower educational attainment, have undergone lymph node removal or dissection, and received radiation therapy.
CONCLUSION: In women with breast cancer and moderate pain, lymphedema is associated with greater pain severity and pain catastrophizing, and decreased ability to complete intermediate ADLs. Women with lymphedema and pain may benefit from tailored, accessible cognitive-behavioral-physiological interventions to improve self-management (eg, Pain Coping Skills Training, interventions to promote lymph flow and reduce inflammation). Disparities in lymphedema prevalence by race and education warrant further exploration.:10.1016/j.clbc.2025.07.008

Magnetic resonance lymphangiography: Correlation with indocyanine green lymphangiography in lower limb lymphedema

Minge Zhang, Liqi Yi, Chong Liu, Jinbiao Huang, Yan Chen, Jingjing Wang, Runyu Tang, Hai Yang. J Plast Reconstr Aesthet Surg. 2025 Aug 5.

BACKGROUND: Indocyanine green (ICG) lymphography is considered the gold standard method for real-time imaging of the lymphatic vessels. Despite extensive literature on the effectiveness of different imaging modalities, research comparing the reliability of ICG lymphography and magnetic resonance lymphangiography (MRL) is limited. We retrospectively analyzed and compared the capability of MRL and ICG lymphangiography to detect lower limb lymphoedema abnormalities.
METHODS: This monocentric cohort study included patients who had examinations and surgeries between September 2021 and December 2023. The assessment comprised scoring the severity levels of the drainage pattern, lymphatic vessel conspicuity, anatomic level of lymphatic vessel enhancement, contrast medium deposition in the foot, and the anatomic coverage of dermal backflow. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRL and ICG lymphangiography were calculated.
RESULTS: A total of 89 patients with clinically proven moderate to severe lymphoedema (stages II-III) affecting 92 lower limbs were enrolled. Good to excellent agreement was determined between MRL and ICG lymphography in drainage pattern (k=0.710), contrast medium deposition in the foot (k=0.933), and anatomic coverage of dermal backflow (k=0.653). Anatomical level of lymphatic vessel enhancement was in moderate correlation (k=0.524), and the visualization of lymphatic vessels was correlated (k=0.330) between the two modalities. MRL demonstrated lower NPV (50% vs 100%) in lymphatic vessel conspicuity but better sensitivity (100% vs 98%) and NPV (100% vs 97.6%) of contrast medium deposition in the foot as compared to ICG lymphography.
CONCLUSIONS: MRL demonstrated better performance on the lymphatic vessel conspicuity when dermal backflow is obvious. For normal lymphatic vessels, ICG lymphography provided a better description.:10.1016/j.bjps.2025.07.034

Does ICG have Time-Dependent Effects on the Lymphatic System in Women after Breast Cancer Surgery?

P Bourgeois, M.M. Roman, C Karler, V. Del Marmol. Lymphology. 2025.

Near infrared fluorescence imaging (NIRFI) with Indocyanine Green (ICG) has been shown to detect lymph leakages and pat-terns in patients with complete axillary lymph node dissection (CALND) for breast cancer. However, ICG has also been demonstrated to have toxic effects in the ophthalmological field and limited data (in animal and human studies) suggest that it can alter functioning of the lymphatic system. The current study investigates pre-operative (Pre) and per-operative (Per) ICG administration and the volumes (V) of liquids collected in drains (Vd) and/or punctures (needle aspiration) (Vp) after breast cancer surgery. Fifty-five patients had one subcutaneous ICG injection in the ipsilateral hand either the day before (group Pre; n = 26) or the day of the surgery (group Per: n = 29). Vd, Vp and Vt (=Vd+Vp) were compared. The two groups did not differ statistically. We observed a statistical tendency (p=0.07) to find lower fluid volumes, overall (Vt) and in aspirations (Vp), when ICG was injected the day before the operation (Pre) compared with the same day (Per). When no fluorescence (no lymph leakage from the arm) was detected in the fluid collections, Vd and Vt were statisti-cally significantly lower in the pre-op group and in the whole group but not in the per-op one. Our correlation results add additional evidence to suggest that ICG may have a causative effect on the lymphatic system depending on the duration of its exposure as observed in the ophthalmological field. Although further study is needed to confirm, lymphologists, angiologists, lymphatic surgeons, vascular surgeons, and others who are using ICG for their NIRFLI evaluations should be aware of possible risks and complications associated with this procedure for use in patients with lymphedema.

Usefulness of Ultrasound Assessment of Breast Cancer-Related Lymphedema

Doyoung Yuk, Kyungmin Kim, Kyeong Eun Uhm, Lymphat Res Biol. 2025 Aug 22.

Background: Lymphedema, a common side effect of breast cancer treatments, affects 20%-40% of patients. Ultrasound evaluation measures structural change as well as skin and subcutaneous tissue thicknesses to assess lymphedema severity. This study aimed to investigate the usefulness of ultrasound evaluation as an outcome measure of lymphedema in patients with breast cancer.
Methods and Results: Thirty-one patients with unilateral breast cancer-related lymphedema were enrolled. Arm circumferences were measured at four points, as the Relative Metric Coefficient of Arm Lymphedema (RMCAL). The thickness of the skin and subcutaneous tissue was measured using ultrasound at four points of the upper arm and forearm, comparing both sides. Subcutaneous echogenicity grade (SEG) and subcutaneous echo-free space (SEFS) grade were assessed following the method described by Suehiro et al. Lymphoscintigraphy evaluated axillary lymph node uptake and dermal backflow. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module 23 (EORTC QLQ-BR23). Increase ratios of skin and subcutaneous tissue thickness, SEG, and SEFS were well correlated with RMCAL value. Additionally, the increase ratio of subcutaneous tissue was significantly different according to the abnormality of axillary lymph node uptake on lymphoscintigraphy. However, ultrasound parameters did not significantly associate with functional and symptom scales of EORTC QLQ-BR23.
Conclusions: Ultrasound parameters were well correlated with arm circumferences. Furthermore, subcutaneous tissue thickness on ultrasound was significantly related to lymphatic function assessed by lymphoscintigraphy.:10.1177/15578585251370750

Management Strategies

Treating cellulitis promptly with compression therapy reduces C-reactive protein-levels and symptoms – a randomized-controlled trial

Sören Dräger, Charlotte Kiehne, Greta Zinser, Birgit Kahle. J Dtsch Dermatol Ges. 2025 Aug 11.

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Efficacy of Compression Stockings in Prophylaxis of Lower Limb Lymphedema in Women Undergoing Treatment for Gynecological Malignancies: A Prospective Randomized Study

Joanna Kurpiewska-Pieniążek, Katarzyna Ochałek, Tomasz Grądalski, Andrzej Szuba. Cancers (Basel). 2025 Jul 31.

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A qualitative study on the post-discharge self-management experiences and needs of patients with secondary lymphedema

Yinyin Guan, Hui Ju, Lanwei Xu, Zhenzhen Wan, Lei Ge, Yuxia Fang. Medicine (Baltimore). 2025 Aug 15.

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Impact of a self management mobile application on quality of life and limb circumference in women with breast cancer related lymphedema

Mehrvash Hemati, Zahra Khademian, Mozhgan Rivaz, Sedigheh Tahmasebi. Sci Rep. 2025 Aug 18

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Effects of resistance exercise on reducing the risk of lower-limb lymphedema after gynecological cancer surgery

Yu-Yun Hsu, Cheng-Feng Lin, Pei-Chi Liang, Tram Thi Bich Nguyen, Keng-Fu Hsu. Asia Pac J Oncol Nurs. 2025 Jul 14. 

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The Management of Head and Neck Lymphoedema: A 2025 Systematic Review

Rohan Rajaram, Jenny Lee, Evania Lok, Sally Ng, Takumi Yamamoto. Head Neck. 2025 Aug 4.

BACKGROUND: Head and Neck Lymphoedema (HNL) is debilitating to many domains of patients’ structure and function, yet it is the most poorly researched form of lymphoedema. This is due to the variety of signs and symptoms experienced by HNL patients, and this makes it difficult to formulate standardized staging classifications and treatment algorithms. The lymphatic drainage pathway within the head and neck is also highly variable. Currently, there is no gold standard therapy or treatment algorithm for HNL. This leaves many patients with the burden of undergoing suboptimal and unverified treatment to varying degrees of success.
METHODS: A PRISMA 2020 checklist adherent systematic review was conducted. Medline-OVID was queried with keywords based on HNL and its various management modalities. Title and abstract screening and subsequent full text screening were undertaken by two independent reviewers.
RESULTS: Thirty-seven studies encompassing a sample size of 1452 were discovered from 602 initial results. Overall, the evidence base was weak with many case reports and studies. Complete Decongestive Therapy provided the largest and most consistent data. Surgical methodologies appear to provide significant benefit when cases are selected carefully for appropriateness. Other dermatological and pharmaceutical methods are promising but suffer from a lack of evidence.
CONCLUSION: The research base on HNL is limited by a lack of standardized severity scale, and the championing of such may encourage higher quality studies to be undertaken.:10.1002

Health coaching in lymphedema care: A review of benefits for cancer survivors

Loredana Corrias, Danilo Donati, Federica Giorgi, Roberto Tedeschi. Phlebology. 2025 Jul 31.

Background: Lymphedema, particularly in cancer survivors, is a chronic, debilitating condition that lacks a definitive cure. Current management strategies are complex and focus on symptom control. Health coaching (HC) has emerged as a promising intervention to enhance patient self-management and quality of life in chronic diseases, but its specific role in lymphedema care remains underexplored.
Methods: This review synthesized findings from existing literature reviews and systematic reviews examining HC’s effectiveness in improving health outcomes in chronic conditions, including lymphedema. Databases searched included MEDLINE, Cochrane Central, Scopus, PEDro, and Web of Science, with no date limitations. Five relevant studies were identified, each evaluating HC’s impact on quality of life, mental health, physical activity, self-management, and decision-making.
Results: The reviewed studies consistently indicated that HC enhances quality of life, reduces mental distress, and supports self-management in chronic conditions. Improvements were also noted in patient engagement in physical activity and informed decision-making. However, outcomes varied in sustainability and were influenced by HC delivery method and duration.
Conclusions: The findings suggest that HC, delivered within multidisciplinary teams, could be a valuable addition to lymphedema management by empowering patients, improving adherence to care routines, and enhancing psychological resilience. Future research should standardize HC protocols and assess their long-term benefits specifically for lymphedema. This review highlights HC’s potential in chronic disease care and the need for tailored interventions in lymphedema.:10.1177/02683555251365058

Effectiveness of Twice-Daily Complete Decongestive Therapy in Reducing Limb Volume in Children with Lymphedema: A Retrospective Study

David A. Doubblestein, Deanne Fay, Sarah Brunskill, Betty Westbrook, Brittany Williams. Lymphat Res Biol. 2025 Aug 11. 

Aim: To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema.

Methods: A retrospective cohort study was conducted using rehabilitation records of children aged 5-17 years from Camp Watchme, a North American summer camp providing lymphedema interventions.

Results: Over 4 years, 38 unique campers contributed 66 records for analysis. The majority were female (68.42%), with a mean age of 9.30 ± 2.66 years. Lower extremity limb volume demonstrated statistically significant reductions across all 4 years (2021, p = 0.011; 2022, p = 0.030; 2023, p < 0.001; 2024, p < 0.001). Cumulative analysis of upper extremities (n = 16) also showed significant volume reduction (p = 0.042, r = 0.50). Daily measurement tracking (n = 43) indicated consistent percent volume decreases, with confidence intervals supporting a meaningful change for lower extremity limb volume differences across 4 years. Conclusion: An intensive, short-duration CDT intervention significantly reduces limb volume in pediatric patients with lymphedema. Future research should explore long-term effects, optimize CDT protocols, and assess broader functional and psychosocial outcomes to enhance pediatric lymphedema management.:10.1177/15578585251367334

Experiences of complete decongestive therapy for patients with lower limb lymphedema: A descriptive phenomenological study

Yucheng Yin, Jie Lin, Lixia Yang, Yuanyuan Zhao, Lili Zhu, Luya Pu, Dongmei Han. J Psychosom Res. 2025 Aug 15.

BACKGROUND: Lower limb lymphedema can cause significant physical and psychological distress. Complete decongestive therapy is recognized as the gold standard for non-surgical management of this condition. However, the lived experiences of patients undergoing complete decongestive therapy have been largely overlooked in existing research.
OBJECTIVES: To explore the experiences of individuals with lower limb lymphedema undergoing complete decongestive therapy.
METHODS: A total of 18 eligible participants with lower limb lymphedema, aged 39-72 years, were recruited through purposive sampling from a hospital in China. One-on-one in-depth interviews were conducted to collect qualitative data. Nvivo12.0 was used for data encoding and management, and Colaizzi’s descriptive analysis framework was employed for data interpretation.
RESULTS: Four major themes and thirteen subthemes were generated from the data analysis: (a) Physical discomfort, (b) Increased confidence, (c) Emotional distress, and (d) Need for support.
CONCLUSION: People undergoing complete decongestive therapy for lower limb lymphedema experience complex physical, emotional, and psychological challenges. Interventions to enhance the complete decongestive therapy experience should focus on five key areas: health education, psychological support, advancements in medical devices, the establishment of consultation platforms, and addressing self-care difficulties among individuals living alone.:10.1016/j.jpsychores.2025.112351

Advancing self-management for head and neck cancer-related lymphedema: A promising step forward

Jian Zhang, Dong-Mei Liu. Oral Oncol. 2025 Aug 20.

Head and neck cancer (HNC) survivors often experience debilitating lymphedema and fibrosis (LEF). Deng et al conducted a pilot randomized controlled trial (RCT) evaluating a 6-week Lymphedema and Fibrosis Self-Management Program (LEF-SMP), demonstrating high feasibility (93 % adherence) and preliminary efficacy in improving neck mobility, fibrosis symptoms, and quality of life (QoL). While promising, larger, longer-term studies are needed to confirm effectiveness, optimize delivery such as integrating digital health, and ensure accessibility. This study highlights the potential of self-management strategies to empower HNC survivors, complementing traditional therapies and addressing a critical gap in survivorship care. Future research should prioritize diverse populations and cost-effectiveness analyses to enhance clinical implementation.:10.1016/j.oraloncology.2025.107611