Hot off the Press July 2026

Article to ponder

ICG lymphography improves lymphedema diagnosis by providing real-time visualization of lymphatic flow and drainage pathways. It supports more accurate staging and personalized treatment, with emerging evidence suggesting it may improve patient outcomes and overall lymphedema management.

Enhancing Diagnostic Precision and Treatment Effectiveness Using Indocyanine Green Lymphography in Lymphedema.

Suami, Hiroo, and Jin A. Yoon. Annals of rehabilitation medicine.

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Key Takeaway: ICG lymphography enhances lymphedema diagnosis and enables more personalized treatment by providing real-time visualization of lymphatic flow and drainage pathways

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

Critical role of keratinocytes and protease-activated receptor 2 in secondary lymphedema development

Hyeung Ju Park, Sarit Pal, Xizhao Chen, Jinyeon Shin, Gabriela D. García Nores, Jung Eun Baik, Annica Stull-Lane, Abraham J. Book, Cristina C. Clement, Elizabeth M. Encarnacion, Mark G. Klang, Elyn Riedel, Tafadzwa L. Chaunzwa, Geoffrey E. Hespe, Laura Santambrogio, Michelle Coriddi, Joseph H. Dayan, Babak J. Mehrara, Raghu P. Kataru. Clin Transl Med. 2026 Jun 16. 

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Inflammatory Markers in Lipedema: A Comparative Analysis of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume

Ayla Cagliyan Turk, Ender Erden, Pinar Borman. Lymphat Res Biol. 2026 Jun 9:1557 858 52.

BACKGROUND/AIM: Although various distinctive morphological features such as hyperproliferation of adipocytes, fibrosis, and inflammation have been described in the progression of lipedema, the underlying mechanisms of these changes are not yet fully understood. In this study, we aimed to investigate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) to demonstrate the role of inflammation in lipedema.
METHODS: The retrospective study consisted of 60 lipedema patients (Group 1) and 40 healthy controls (Group 2). The age, height, weight, and body mass index (BMI) of all participants were recorded, along with the lipedema type and stage for Group 1. Laboratory results, including complete blood count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), were obtained for all participants. Hemoglobin, leukocyte, lymphocyte, neutrophil, and platelet counts, NLR, PLR, MPV, PDW, CRP, and ESR were evaluated.
RESULTS: The mean age was 45.45 ± 10.17 years in Group 1 and 44.90 ± 10.69 years in Group 2; the BMI was 32.15 ± 5.05 in Group 1 and 30.94 ± 4.98 in Group 2, with no significant difference between the groups (p > 0.05). The most common type was Type 2 lipedema. Platelet counts, CRP, NLR, and PLR levels were significantly higher in Group 1 than in Group 2 (p < 0.05). There was no difference between groups in MPV and PDW values (p > 0.05). There was a positive correlation between BMI and both leukocyte count and CRP levels (p < 0.05).
CONCLUSION: In our study investigating inflammation in lipedema-an etiology that is still not fully understood-NLR, PLR, platelet count, and CRP levels were found to be significantly higher in the patient group. The increase in BMI was correlated with leukocyte count and CRP levels. This finding is important for elucidating the etiopathogenesis of the disease, and we believe it may guide future research in this area.:10.1177/15578585261454779

Neuropathic Pain Features in Lipedema Compared to Lymphedema: An Exploratory Cross-Sectional Study

Seçil Pervane, Öznur Uzun. Lymphat Res Biol. 2026 Jun 8:1557 858 52.

BACKGROUND: Lipedema is a chronic connective tissue disorder characterized by painful subcutaneous adipose accumulation, mainly in the lower extremities. Pain is a hallmark feature, yet its mechanisms remain poorly defined. Neuropathic components may contribute, but direct comparisons with lymphedema are scarce.
METHODS: In this exploratory cross-sectional study, 118 female patients with lipedema (n = 62) or bilateral lower extremity lymphedema (n = 56) were assessed. Pain intensity was measured with the Visual Analogue Scale (VAS). Neuropathic pain was evaluated with painDETECT and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). Psychological status was measured using the Hospital Anxiety and Depression Scale (HADS), cognitive-emotional aspects with the Pain Catastrophizing Scale (PCS), and health-related quality of life with the WHOQOL-BREF.
RESULTS: Lipedema patients reported higher pain severity (VAS 6.2 ± 1.4 vs. 5.5 ± 1.5, p = 0.02) and greater neuropathic pain prevalence (42% vs. 21%, p < 0.01) than lymphedema. painDETECT and LANSS scores were significantly higher in lipedema (p < 0.001). HADS-Anxiety (10.2 ± 3.8 vs. 7.8 ± 3.5, p = 0.005) and PCS scores (29.5 ± 7.2 vs. 25.4 ± 6.5, p = 0.03) were also elevated, while HADS-Depression was slightly higher in lymphedema without significance. WHOQOL-BREF scores were similarly reduced in both groups compared to population norms. Correlation analyses showed strong associations between pain intensity, neuropathic features, catastrophizing, and anxiety, particularly in lipedema.
CONCLUSIONS: A substantial proportion of lipedema patients exhibit neuropathic pain features and higher pain severity compared with lymphedema, while anxiety and pain catastrophizing appear to amplify symptom burden; however, quality-of-life impairment is substantial in both conditions, and the findings should be interpreted as hypothesis-generating with implications for more individualized management approaches.:10.1177/15578585261454778

Prevalence and Risk Factors

Lymphedema of the Breast Following Partial Mastectomy and Oncoplastic Reduction

Shahnur Ahmed, Dylan Roth, Luci A. Hulsman, Rachel M. Danforth, Ravinder Bamba, Kandice K. Ludwig, Mary E. Lester, Karl Y. Bilimoria, Carla S. Fisher, Aladdin H. Hassanein. Lymphatics. 2026 Apr 22. 

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Breast Edema in Women With Arm Lymphedema Following Breast-Conserving Surgery: A Systematic Review

Pierina S. Barletti, Megan T. Moldovan, Maliha Latif, Shanelle Bryan, Grace Blair, Harvey N. Mayrovitz. Cureus. 2026 May 2

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Development and validation of an interpretable stacking-based risk model for breast cancer- related lymphoedema: a cross-sectional study

Ke-Ming Ying, Cheng-Xue Dang, Qing Zhou, Han Xue. Front Oncol. 2026 May 29

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Pilot Study: ChatGPT-enabled Task Sharing and Team Building Improve Workflow in Lymphedema Care

Makoto Mihara, Hisako Hara, Yohei Iwanaga, Hiroki Yoshida. Plast Reconstr Surg Glob Open. 2026 Jun 12. Jun

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Assessment

Lipedema: Exploring Relationship Between Physical and Psychological Symptoms in Affected Patients-A Mixed-Methods Study

Bastien Seynhaeve, Velika Stoichkova, Jean-Paul Belgrado, Estelle Janssens, Eline Lison, Jennifer Foucart. Lymphat Res Biol. 2026 Jun 6:1557 858 52.

BACKGROUND: Recent studies have consistently shown that patients with lipedema are at a higher risk for depression and anxiety. The aim of this study is to identify the psychological factors associated with lipedema syndrome (LS) and their link to the patient’s psychological symptomatology.
METHODS: A mixed- methods approach was employed, combining quantitative and qualitative components. The quantitative component involved anonymous online questionnaires, including a Health and Demographic Questionnaire, the body satisfaction and global self-perception questionnaire (BSGSPQ), the lymphedema quality of life questionnaire (LYMQOL), and the Hospital Anxiety and Depression Scale (HADS). The qualitative component consisted of oral interviews to explore the complexity of the phenomenon. Participants included those with “easy bruising,” a waist-to-hip ratio ≤0.7 (W/H), and pain levels ≥4/10 on the visual analogue scale (VAS).
RESULTS: Our findings indicate that the level of depression is positively correlated with spontaneous pain (p = 0.002; r = 0.331) and the lack of medical understanding (p = 0.011; r = 0.229). Anxiety scores are inversely correlated with body satisfaction (r = -0.317) and global self-perception (r = -0.393); similarly, depression scores show similar correlations with body satisfaction (r = -0.445) and global self-perception (r = -0.608), all with p value of <0.0001.
DISCUSSION AND CONCLUSION: This study highlights significant connections between the physical symptoms and mental health in patients with LS. The more affected the self-perception, the greater the depression and anxiety levels. These multiple contributing factors may explain the decline in quality of life (QOL) and deterioration of mental health. It is therefore crucial to proactively integrate mental health management into the care of LS patients. Future research should focus on identifying concrete, actionable methods to support women experiencing LS.:10.1177/15578585261454789

A Study on the Association Between Preventive Behaviors and Quality of Life in High-risk Populations for Postoperative Lymphedema Following Breast Cancer Surgery

Chen Li, Xianhua Li, Qin Xu, Jing Zhao, Lvling He, Jing Lu, Dan Zhang. Clin Breast Cancer. 2026 May 18.-38.

BACKGROUND: Postoperative lymphedema is a chronic complication that impairs quality of life (QoL) in breast cancer survivors. Preventive behaviors are key to mitigation, but their relationship with QoL in high-risk populations requires further investigation.
PATIENTS AND METHODS: A cross-sectional study enrolled 276 high-risk post-surgical breast cancer patients. A self-developed preventive behavior questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) were used. Data were analyzed with correlation and multivariate regression.
RESULTS: Overall preventive behavior scores were moderate-to-low, with poorest adherence in skin care and exercise. A significant positive correlation was found between the total preventive behavior score and total QoL score (r = 0.45 and P < .01). Regression analysis confirmed that better preventive behaviors significantly predicted higher QoL, particularly in functional and emotional domains (P < .05).
CONCLUSION: Preventive behavior adherence is significantly associated with QoL in high-risk patients. Enhancing behaviors-especially skin care and exercise-can improve QoL. Targeted education and personalized intervention strategies are recommended.:10.1016/j.clbc.2026.05.006

Clinician Perspectives on Implementing Breast Cancer-Related Lymphedema Prospective Screening

Caitlin Kotian, Arshum Mirzaeifard, Elsa Wani, Karen Hock, Katherine Ashworth, Lindsey Sova, Roman Skoracki, Ann Scheck McAlearney, Electra D. Paskett, Tari King, Sara P. Myers. JAMA Netw Open. 2026 May 28

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Patient personas of delayed healthcare-seeking behavior among patients with breast cancer-related lymphedema: A qualitative study

Ling Wang, Shuyu Yan, Runxi Xiao, Yi Chen, Tingting Cai, Qingmei Huang, Yang Yang, Changrong Yuan. Asia Pac J Oncol Nurs. 2026 Apr 22. Dec.

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Development and internal validation of a risk prediction model for ipsilateral upper-limb lymphedema following breast cancer surgery

Yufei Fan, Gaofeng Yang, Yumeng Zeng, Yanfei Lu, Fan Feng, Xiudi Wang. Front Oncol. 2026 Jun 3

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Experiences of Living with Gynecological Cancer-Related Lymphedema Among Patients: A Systematic Review and Thematic Synthesis of Qualitative Studies

Xiaoyu Feng, Jianmei Gong, Shuangying Ma. Patient Prefer Adherence. 2026 Jun 11.

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Management Strategies

Compression Therapy in Human Body Applications: A Systematic Review from Principles to Practice

Pengfei Han, Malte Asseln, Gabrielle Tuijthof, Izadyar Tamadon. Ann Biomed Eng. 2026 Jun 6.

Compression therapy is a common approach of managing diverse pathologies by application of controlled pressure to the body. However, existing studies have investigated compression therapy within individual pathologies. This gap makes it difficult to translate clinical findings into general design principles for compression devices. Therefore, this review synthesizes and assesses existing literature on the biomechanical effects, theoretical models, and characteristics of compression for three representative pathologies, namely Chronic Venous Insufficiency (CVI), edema, and ligament injury, aiming to identify cross-pathological overarching insights that provide unified principles for compression device design. The literature review was conducted using Scopus, PubMed, Web of Science, and a combination of four search strings to retrieve peer-reviewed studies. Eighty-six studies were included addressing the effects and characteristics of compression (CVI: 10, edema: 20, ligament injury: 25) and theoretical models of compression (31 studies). Across three pathologies, overarching insights were identified. First, compression produces three main effects: reducing transmural pressure, increasing interstitial pressure, and increasing joint stiffness. Second, theoretical models collectively show that compression regulates geometry, fluid balance, and stiffness of tissue. Third, therapeutic effects depend on compression characteristics such as mode of operation (static or dynamic), distribution (cyclical, graduated, or uniform), pressure level, and location of compression. This review provides a novel perspective for developing more effective and versatile compression devices in the future.:10.1007

Family engagement in the management of breast cancer-related lymphedema: A qualitative study

Ling Wang, Shuyu Yan, Runxi Xiao, Qi Zhang, Yang Yang, Xi Pan, Yi Chen, Yuhua Yu, Fulei Wu, Changrong Yuan. Int J Nurs Stud. 2026 Jun 3.

BACKGROUND: Breast cancer-related lymphedema is a chronic condition requiring long-term home-based disease management. Family engagement plays a crucial role in facilitating patients’ disease management behaviors, yet the diversity of family engagement patterns and their implications for personalized care approaches remain underexplored.
OBJECTIVE: To identify patient personas based on family engagement profiles in home-based disease management among patients with breast cancer-related lymphedema and to inform personalized support approaches.
METHODS: A qualitative descriptive study was conducted among patients with breast cancer-related lymphedema. The study site is a lymphedema clinic in a tertiary care hospital in mainland China. Data were collected from April to June 2025. Semi-structured interviews explored participants’ perspectives on home-based disease management, management practices, and family engagement. Using NVivo 20.0, content analysis was carried out to code the data, extract themes, and construct personas based on core dimensions of experiences, characteristics, and support needs.
RESULTS: Twenty-three patients with breast cancer-related lymphedema were recruited in this study. Four distinct patient personas emerged: (1) Self-reliant -type – patients who intentionally assume full responsibility for lymphedema management to avoid burdening family members; (2) Unsupported type – patients who desire family help but lack access due to family constraints; (3) Collaborative type – patients who actively involve family members in shared decision-making and care; and (4) Distrustful type – patients who avoid family engagement due to distrust in non-professional care and demonstrate strong reliance on professional medical authority. Each persona requires tailored intervention strategies.
CONCLUSIONS: Understanding family engagement profiles enables healthcare providers to develop personalized support strategies that align with patients’ family dynamics and preferences, potentially improving home-based disease management outcomes and quality of life for women with breast cancer-related lymphedema.:10.1016/j.ijnurstu.2026.105610

The Effect of a Series of Lower Limb Pressotherapy Treatments on the Range of Motion of the Lower Limb Joints, Lower Limb Circumferences, and Body Composition in Young, Healthy Women

Bartłomiej Ptaszek, Oliwia Kurek, Szymon Podsiadło. Lymphat Res Biol. 2026 Jun 20.

PURPOSE: In times when health and physical activity are gaining in value, the search for effective methods to support fitness and improve quality of life is becoming a priority. One of the therapies that is gaining increasing popularity is pressotherapy, which supports the regeneration of the body on many levels.
METHODS: The study was conducted on a group of 15 healthy, young women. The participants underwent 10 pneumatic compression therapy treatments using the CarePump Expert8 device. The participants were examined 4 times: a week before the first treatment, immediately before the first treatment, after the 10th treatment and a week after the 10th treatment.
RESULTS: Statistical analysis of mean changes in the range of motion values showed significant decrease in: right (p < 0.05) and left (p < 0.05) hip joint extension; right (p < 0.05) hip joint horizontal abduction; horizontal adduction of the right (p < 0.05) and left (p < 0.05) hip joint; dorsiflexion of the right (p < 0.05) and left (p < 0.05) ankle joint, and also an increase in: right (p < 0.05) and left (p < 0.05) hip external rotation. Statistical analysis of changes in mean values of circumferences showed significant decrease at all tested levels: P1 right (p < 0.05) and left (p < 0.05); U1 right (p < 0.05) and left (p < 0.05); U2 right (p < 0.05) and left (p < 0.05); K right (p < 0.05) and left (p < 0.05); G1 right (p < 0.05); and left (p < 0.05); G2 right (p < 0.05) and left (p < 0.05).
CONCLUSIONS: A series of pressotherapy sessions did not improve lower limb range of motion or body composition indices; however, it did reduce circumferences at all levels of the lower limbs. Long-term use of pressotherapy can help maintain healthy fluid levels, improve circulation, and improve overall physical fitness.:10.1177/15578585261461974

Best Evidence for the Exercise-Based Management of Lower Limb Lymphedema After Gynecological Cancer: A Systematic Review and Evidence Synthesis

Chaonan Zhang, Kim Lam Soh, Putri Yubbu, Jian Chen, Lizhi Yang, Yingying Chen, Jing Wu. J Multidiscip Healthc. 2026 May 20

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Exercise and physiotherapy for enhancing muscle strength, managing lower-limb lymphedema, and improving sexual function in the treatment and survivorship of gynecological cancers

Yun Huang, YaoChuan Zhang. Front Oncol. 2026 May 20.

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Comprehensive overview of management and risk assessment of breast cancer-related lymphedema: a multidisciplinary approach

Elisheva Knopf, Lily T. Childers, Mackenzie Woodward, Isabella M. Gray, Justin T. Childers, Sarfraz Ahmad. Front Oncol. 2026 May 19.

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Evaluation of Patient-Reported Outcomes in Over 10,000 patients Using Pneumatic Compression Therapy for Lower Extremity Lymphedema

Ashna Raiker, Alisha Raiker, Steven Dean, Antonios Gasparis, Nicos Labropoulos. J Vasc Surg Venous Lymphat Disord. 2026 Jun 2:102548.

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Non-pharmacological therapies for breast cancer-related lymphedema: a systematic review and network meta-analysis based on randomized controlled trials

Ningning Fang, Hong Xin, Mengmeng Wu. Front Oncol. 2026 May 29

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Effects of Resistance Training on Breast Cancer-Related Lymphedema: A Meta-Analysis

Shuwei Wu, Chen Zhong, Zhaoxing Liu. Arch Rehabil Res Clin Transl. 2026 Feb 28. Jun.

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Improvement in chronic lymphedema in a gynecologic cancer survivor after starting GLP-1 receptor agonist therapy: A case report

Andrea Fromson, Christelle David, Cody C. Andrews, Subha Hanif. Gynecol Oncol Rep. 2026 Jun 5. Jun

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