The Diagnostic Approach to Lymphedema: a Review of Current Modalities and Future Developments

The objective of this review is to discuss current modalities and devices as well as highlight promising advancements intended to aid in diagnosing secondary lymp hedema in breast cancer patients.Recent FindingsImaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) can offer high resolution of the lymphatics but are expensive and time-consuming. Single photon emission computed tomography (SPECT) is an alternative that reveals organ function as opposed to organ structure. Other imaging methods, such as color duplex ultrasound (CDU), laser scanner 3D (LS3D), and dual-energy X-ray absorptiometry (DXA), are relatively easy to use, reproducible, and fast to perform. However, the disadvantages of these techniques include lower sensitivity and specificity compared with CT and MRI. Of note, direct imaging techniques are highly effective for the diagnosis of lymphedema because they utilize dyes or radiotracers in order to directly visualize lymphatic vessels. Fluorescent microlymphography (FMLG) and near-infrared imaging (NIR) involve injection of fluorescent dyes that can be excited with light. Lymphoscintigraphy has effectively replaced lymphangiography as the method of choice for the diagnosis of lymphedema because it is safer, less invasive, and has no risk of causing an allergic reaction in patients. Novel approaches that are currently in development include bioimpedance spectroscopy, ultra-high-frequency ultrasound systems (UHFUS), and magnetic ...
Source: Current Breast Cancer Reports - Category: Cancer & Oncology Source Type: research

Related Links:

Publication date: June 2020Source: European Journal of Surgical Oncology, Volume 46, Issue 6Author(s): Pragnya Chigurupati, Arie Hawazie, Rebecca Elwell, Kirti Kabeer, Sekhar Marla, Sadaf Jafferbhoy, Soni Soumian, Sankaran Narayanan
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
ConclusionsScreening and management of distress, problems, and referral wish are important, even years after chemotherapy completion as a substantial proportion of breast cancer survivors continue to report elevated distress and problems. Special attention should be paid to survivors reporting physical problems, especially fatigue and lack of physical fitness, since these problems are most strongly related to continuing elevated distress.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Authors: Jin H, Xiang Y, Feng Y, Zhang Y, Liu S, Ruan S, Zhou H Abstract Objective: To evaluate the effectiveness and safety of acupuncture moxibustion therapy (AMT) for the breast cancer-related lymphedema (BCRL). Methods: Four English databases (MEDLINE, PubMed, Embase, and Cochrane CENTRAL) and four Chinese databases were searched from their inception to Feb 1, 2020. Eligible randomized controlled trials (RCTs) investigating AMT against any type of controlled intervention in patients for BCRL and assessing clinically relevant outcomes (total effective rate, circumference difference, and Karnofsky performance...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Conclusion Complete removal of the axillary scar tissue after breast cancer treatment and re-augmentation of the axilla with a turnover flap results in a reduction in ipsilateral lymphedema and an improvement in pain and quality of life. We interpret these findings as a result of the physiological re-alignment of the lymphatic vessels combined with a lymph node-containing local transposition flap. Therefore, re-augmentation with a turnover flap could be an effective non-microsurgical alternative to lymph node transplantation. PMID: 32435069 [PubMed]
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
AbstractPurpose of ReviewThe purpose of this narrative review was to highlight rehabilitation-relevant aspects of cancer treatment and primarily musculoskeletal impairments and rehabilitation interventions among women with breast and gynecologic cancers. For breast cancer, we reviewed post-mastectomy pain syndrome, upper quadrant dysfunction, aromatase inhibitor musculoskeletal syndrome (AIMSS), and lymphedema. For gynecologic cancers, pelvic floor dysfunction, lymphedema, and insufficiency fractures were selected.Recent FindingsThe recent breast cancer rehabilitation literature evaluates the pathophysiology of impairments...
Source: Current Physical Medicine and Rehabilitation Reports - Category: Rehabilitation Source Type: research
BACKGROUND: The cost effectiveness of combining vascularized lymph node transfer (VLNT) with autologous breast reconstruction has not been established. Herein we describe the use of Markov modeling to evaluate the cost utility of VLNT with delayed autologous breast reconstruction for patients with breast cancer related lymphedema (BCRL).METHODS: We conducted a cost effectiveness analysis using a Markov model with microsimulation. The characteristics and associated life expectancy of the hypothetical patients were derived from the Surveillance, Epidemiology, and End Results database.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Source Type: research
Condition:   Lymphedema Intervention:   Drug: Tacrolimus ointment Sponsor:   Odense University Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionThese findings suggest ICG lymphography, through the identification of morphological lymphatic changes, is a potential qualitative objective assessment technique for breast lymphoedema. Furthermore, in this group of breast lymphoedema patients it identified changes to the normal drainage pathway of the breast. Understanding these changes will have implications for clinical management.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Purpose: Breast cancer is the most common cancer amongst women both in Turkey and in the world. Lymphedema, which negatively affects the quality of life, is one of the most prevalent problems reported by breast cancer survivors. Upper Limb Lymphedama 27 (ULL-27) questionnaire is a valid and reliable tool that assesses the quality of life in patients with breast cancer-related lymphedema. Until now, a Turkish-language version was lacking. The aim of this study was to perform a cross-cultural validation and reliability of the Turkish version of the ULL-27 questionnaire.Methods: This cross-sectional study involved forward- ba...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
More News: Allergy & Immunology | Breast Cancer | Cancer | Cancer & Oncology | CT Scan | DEXA Scan | Lymphedema | Lymphoscintigraphy | MRI Scan | PET Scan | SPECT | Ultrasound