Prediction of breast cancer-related lymphedema by dermal backflow detected with near-infrared fluorescence lymphatic imaging

• DOI: 10.1007/s10549-022-06667-4
• Publication Date: 2022-07-11T12:03:34Z
• Authors: Melissa B. Aldrich; John C. Rasmussen; Sarah M. DeSnyder; Wendy A. Woodward; Wenyaw Chan; Eva M. Sevick-Muraca; Elizabeth A. Mitt...; Benjamin D. Smith; Michael C. Stauder; Eric A. Strom; George H. Perkins; Karen E. Hoffman; Melissa P. Mitchell; Carlos H. Barcenas; Lynn E. Isales; Simona F. Shaitelman
• Keywords: Backflow

Abstract Purpose Mild breast cancer-related lymphedema (BCRL) is clinically diagnosed as a 5%–10% increase in arm volume, typically measured no earlier than 3–6 months after locoregional treatment. Early BCRL treatment associated with better outcomes, yet amid increasing evidence that exists latent form, delayed until swelling obvious. In this study, we investigated whether near-infrared fluorescence lymphatic imaging (NIRF-LI) surveillance could characterize early onset of peripheral dysfunction predictor BCRL. Methods prospective, longitudinal cohort/observational study (NCT02949726), subjects locally advanced cancer who received axillary lymph node dissection and regional nodal radiotherapy (RT) were followed serially, between 2016 2021, before surgery, 4–8 weeks 6, 12, 18 RT. Arm volume was by perometry, (dys) function assessed NIRF-LI. Results By RT, 30 42 (71%) developed mild–moderate (i.e., ≥ 5% relative to baseline), all manifested “dermal backflow” into capillaries or interstitial spaces. Dermal backflow had an 83% positive predictive value 86% negative for BCRL, sensitivity 97%, specificity 50%, accuracy 83%, likelihood ratio 1.93, 0.07, odds 29.00. appeared on average 8.3 months, but up 23 the mild Conclusion can be predicted dermal backflow, which often appears swelling, enabling edema irreversible tissue changes.