Lymphatic research and biology最新文献

{"title":"Inflammatory Markers in Lipedema: A Comparative Analysis of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume.","authors":"Ayla Cagliyan Turk, Ender Erden, Pinar Borman","doi":"10.1177/15578585261454779","DOIUrl":"10.1177/15578585261454779","url":null,"abstract":"<p><strong>Background/aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i> > 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 (<i>p</i> < 0.05). There was no difference between groups in MPV and PDW values (<i>p</i> > 0.05). There was a positive correlation between BMI and both leukocyte count and CRP levels (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"188-195"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphedema Care after Breast Cancer Surgery: Insights from a New Meta-Analysis.","authors":"Zhong Yan, Fu Jiejie, Song Wenhua, Kong Yilin","doi":"10.1177/15578585261438419","DOIUrl":"10.1177/15578585261438419","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema is a common complication after breast cancer surgery that significantly affects quality of life. This study aimed to synthesize current evidence on effective interventions for lymphedema care postsurgery.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Cochrane Library, and Scopus to identify randomized controlled trials and observational studies published until September 2024. Included studies evaluated interventions for preventing and managing lymphedema, such as physical therapy [manual lymphatic drainage (MLD), exercise], compression therapy, and pharmacological treatments, reporting on lymphedema incidence, severity, or quality-of-life outcomes. Data were extracted by two independent reviewers, and a random-effects model estimated pooled effect sizes. Subgroup analyses were based on intervention types and design.</p><p><strong>Results: </strong>Nine studies comprising 1183 patients were included. The pooled lymphedema incidence in control groups was 22.5% [95% confidence interval (CI): 19.3%-26.1%]. MLD reduced lymphedema incidence by 38% [risk ratio (RR) = 0.62, 95% CI: 0.52-0.74], whereas compression therapy decreased limb circumference by 15% (standardized mean difference = -0.33, 95% CI: -0.46 to -0.19). Exercise programs offered a 12% risk reduction (RR = 0.88, 95% CI: 0.76-1.03). Combined interventions, such as MLD with compression garments, yielded a 44% reduction in incidence (RR = 0.56, 95% CI: 0.47-0.67) and significantly improved quality of life (mean Functional Assessment of Cancer Therapy-Breast difference = 7.4, 95% CI: 5.1-9.7). Early and integrated care approaches showed the greatest benefit.</p><p><strong>Conclusions: </strong>This meta-analysis confirms MLD and compression therapy's effectiveness in managing postsurgical lymphedema. A multimodal approach provides optimal outcomes for reducing lymphedema burden and improving quality of life.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"145-152"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Sodium Response to Complete Decongestive Therapy in Lower Extremity Lymphedema.","authors":"Shannon L Taylor, Vanessa N Crain, Paula M C Donahue, Sheau-Chiann Chen, Michael D Pridmore, Maria E Garza, John A Beasley, Miracle P Darrington, Allison O Scott, Cheyenne N Whaley, Yu Luo, Alaina J Brown, Rachelle L Crescenzi","doi":"10.1177/15578585261419376","DOIUrl":"10.1177/15578585261419376","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity lymphedema affects a growing number of cancer survivors. Standard-of-care therapy for lymphedema is complete decongestive therapy (CDT), yet the primary outcome measurement of therapeutic efficacy is limb volume, which is relatively insensitive to both well-managed and severe disease. The primary goal of this study was to examine whether physiological sodium magnetic resonance imaging (²³Na-MRI) is sensitive to the effect of CDT on leg lymphedema, and how this effect compares with the measurement reproducibility limits.</p><p><strong>Methods and results: </strong>Participants with lymphedema (<i>n</i> = 11) underwent ≥5 sessions of CDT per participant in their affected leg(s) (<i>n</i> = 12) over 9.2 ± 5.6 weeks, following individual treatment plans with a licensed therapist. At the baseline visit and intervention visit, at least one leg was scanned with ²³Na-MRI to measure tissue sodium content (TSC) in the skin, muscle, and adipose tissue. Control subjects (<i>n</i> = 16) were scanned at two visits separated by a similar timeframe with no treatment to establish measurement reproducibility. Skin TSC significantly reduced by 4.32 mmol/L (<i>p</i> = 0.027) in affected legs treated by CDT, a change greater than the reproducibility coefficient (RPC) (3.82 mmol/L) in controls. Adipose TSC decreased in treated legs (2.27 mmol/L; <i>p</i> = 0.046), a change less than the RPC (5.83 mmol/L). Muscle TSC (<i>p</i> = 0.171) and leg circumference (<i>p</i> = 0.764) did not decrease in treated legs.</p><p><strong>Conclusions: </strong>TSC is reduced in the skin of affected legs with lymphedema treated by CDT, which is observable within the reproducibility limits of ²³Na-MRI. Results provide a basis for applying sodium MRI to observe the physiological effects of emerging lymphedema therapies.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"129-137"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"²³Na-MRI Measures Tissue Sodium in Human Leg Lymphedema.","authors":"Shannon L Taylor, Vanessa N Crain, Sheau-Chiann Chen, Michael D Pridmore, Maria E Garza, John A Beasley, Cheyenne N Whaley, Miracle P Darrington, Allison O Scott, Megan Aumann, Yu Luo, Akwasi Opoku, Nelson Nwumeh, Alaina J Brown, Paula M C Donahue, Rachelle L Crescenzi","doi":"10.1177/15578585261452761","DOIUrl":"10.1177/15578585261452761","url":null,"abstract":"<p><strong>Background: </strong>There are few objective tools to quantify lymphatic disease changes in anatomy and physiology of affected tissues. Tissue sodium could be a relevant physiological indicator of lymphatic disease. However, the importance of sodium to lymphatic physiology in humans has not been well-characterized nor exploited for clinical applications due to a lack of imaging methods to observe sodium and lymphatics together <i>in vivo</i>. The purpose of this study was to apply ²³Na-MRI to measure tissue sodium content (TSC) in human subjects with or without lower extremity lymphedema (LEL) and investigate the relationship between lymphatic dysfunction and tissue sodium.</p><p><strong>Methods and results: </strong>A prospective, cross-sectional observational clinical trial enrolled participants with LEL and controls without lymphedema. ²³Na-MRI measured standardized TSC in the mid-calf. For each leg with lymphedema, clinical stage was determined by a licensed clinician, and lymphedema severity was determined by radiology assessment of noncontrast hydrogen (¹H)-magnetic resonance lymphangiography (MRL). Linear mixed-effects models determined differences in TSC between cases and controls and measured the association of TSC with clinical stage and lymphedema severity. Image subregions were analyzed to observe spatial patterns of TSC involvement. Results found that TSC was nearly 50% higher in lymphedema (<i>n</i> = 52 legs) in the skin (1.51-fold) and adipose tissue (1.47-fold) compared with controls (<i>n</i> = 31 legs; <i>p</i> < 0.001) and was directly related to both clinical stage and lymphedema severity by ¹H-MRL in the skin (<i>p</i> < 0.001) and adipose tissue (<i>p</i> < 0.001). TSC accumulated in patterns in the anterior subcutaneous adipose tissue, increasing with disease severity.</p><p><strong>Conclusion: </strong>²³Na-MRI demonstrates that standardized TSC is distinctly elevated in lymphedema, sensitive to lymphedema disease severity, and a potential objective imaging tool for evaluating lymphedema in future clinical trials.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"163-173"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Predictors of Cancer-Related Fatigue in Breast Cancer-Related Lymphedema Patients: A Cross-Sectional Study.","authors":"Yanfei Liu, Luxin Wang, Xincan Zhou, Zhiyue Li, Xiao Ruan, Han Su, Weihong Zhang, Fangyuan Liu","doi":"10.1177/15578585261461399","DOIUrl":"https://doi.org/10.1177/15578585261461399","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer-related fatigue (CRF) is the most common symptom of cancer patients. This study aimed to investigate the prevalence of CRF among patients with breast cancer-related lymphedema (BCRL) and to indentify the factors associated with its occurrence.</p><p><strong>Methods: </strong>In this cross-sectional study, women with BCRL (<i>N</i> = 260) were recruited from the three general hospitals. Lymphedema status was determined using the Norman telephone questionnaire as the patient-reported occurrence of hand/lower arm/upper arm swelling. CRF status was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire. Multiple binary logistic regression analysis was used to identify factors associated with CRF.</p><p><strong>Results: </strong>The median time from BC diagnosis was 29 months (interquartile range, 15.0-62.0 months). The prevalence of CRF among BCRL patients was 88.46%. The median sedentary time was 245 min/day (IQR: 150-330min/day), and 34.23% of the patients did not meet the moderate-intensity physical activity level. Abnormal postoperative wound healing status, radiotherapy, hormonal therapy, lymphedema severity and failure to meet moderate-intensity physical activity level were associated with an increased risk of CRF.</p><p><strong>Conclusion: </strong>CRF is highly prevalent among patients with BCRL. Targeted interventions aimed at promoting moderate-intensity physical activity and improving long-term symptom management may help alleviate fatigue.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261461399"},"PeriodicalIF":1.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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.","authors":"Bartłomiej Ptaszek, Oliwia Kurek, Szymon Podsiadło","doi":"10.1177/15578585261461974","DOIUrl":"https://doi.org/10.1177/15578585261461974","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Statistical analysis of mean changes in the range of motion values showed significant decrease in: right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05) hip joint extension; right (<i>p</i> < 0.05) hip joint horizontal abduction; horizontal adduction of the right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05) hip joint; dorsiflexion of the right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05) ankle joint, and also an increase in: right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05) hip external rotation. Statistical analysis of changes in mean values of circumferences showed significant decrease at all tested levels: P1 right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05); U1 right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05); U2 right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05); K right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05); G1 right (<i>p</i> < 0.05); and left (<i>p</i> < 0.05); G2 right (<i>p</i> < 0.05) and left (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261461974"},"PeriodicalIF":1.7,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinico-Functional Correlation of Upper Extremity Lymphedema Severity in Patients with Breast Cancer.","authors":"Byeong Ju Lee, In Joo Kong, Jin A Yoon","doi":"10.1177/15578585261419368","DOIUrl":"10.1177/15578585261419368","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between clinical severity and lymphatic function of breast cancer-related lymphedema.</p><p><strong>Methods and results: </strong>A total of 151 patients with lymphedema after breast cancer-related mastectomy were enrolled. The clinico-functional correlation was determined after examining lymphatic function via indocyanine green (ICG) lymphography in patients with breast cancer-related lymphedema and the severity of edema and degree of fibrosis via ultrasound, bioimpedance analysis, and tissue dielectric constant of the upper extremity. The results indicated a significant correlation of ICG dermal backflow (DB) patterns with subcutaneous thickness, limb index ratio, and the extracellular fluid accumulation in the affected side in the medial and lateral forearm and hand. However, no significant correlation was observed between ICG DB patterns and parameters related to fibrotic changes of the lesion, including regional resistance to compression and shear wave velocity.</p><p><strong>Conclusion: </strong>In patients with upper-extremity lymphedema, superficial lymphatic function had a significant correlation with subcutaneous edema and extracellular fluid accumulation.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"114-120"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Skin Viscoelasticity in Breast Cancer-Related Lymphedema-Relationship with Subcutaneous Thickening and Fluid Retention.","authors":"Shiori Niwa, Ayana Mawaki, Keisuke Nakanishi, Fumiya Hisano, Kako Tsukioka, Atsushi Fukuyama, Toyone Kikumori, Kazuhiro Shimamoto, Kuniharu Imai, Etsuko Fujimoto, Chika Oshima","doi":"10.1177/15578585261419370","DOIUrl":"10.1177/15578585261419370","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer-related lymphedema (BCRL) is associated with lymphatic fluid accumulation and subcutaneous tissue thickening, influencing the skin's biomechanical properties. Although several studies have used the Cutometer® to assess skin elasticity in lymphedema, the relationship between viscoelastic parameters and subcutaneous fluid retention remains unclear. This study aimed to clarify how skin viscoelasticity relates to subcutaneous tissue thickening and fluid accumulation in patients with BCRL.</p><p><strong>Methods and results: </strong>The study included 17 women who underwent unilateral breast cancer treatment and subsequently developed BCRL; 3-Tesla magnetic resonance imaging (MRI) system was used to confirm subcutaneous lymphedema. An ultrasound device was used to measure skin and subcutaneous tissue thickness, and Cutometer® was used to measure skin elasticity. Based on all measurement sites were categorized into the following three groups according to the presence or absence of lymphatic fluid accumulation, based on MRI results: with water, without water, and unaffected side. Among the 10 skin viscoelasticity parameters, significant differences were observed among the three groups for Ur (immediate retraction), Ur/Ue (net elasticity), and Ur/Uf (biological elasticity). Spearman's rank correlation coefficient showed that Ur was not significantly correlated with skin thickness (ρ = 0.072, <i>p</i> = 0.56) or subcutaneous thickness (ρ = 0.197, <i>p</i> = 0.107).</p><p><strong>Conclusion: </strong>Ur was not significantly associated with tissue thickness, suggesting its sensitivity to lymphatic fluid accumulation. Ur may be a sensitive indicator for detecting subcutaneous fluid retention in BCRL. As a noninvasive parameter, it could complement current diagnostic tools and may be useful for longitudinal BCRL monitoring.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"121-127"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Tissue Water Variations in Women at Risk of Developing Arm Lymphedema Following Breast Cancer Treatment-A Retrospective Study.","authors":"Katarina Blom, Christina Brogårdh, Lena Nilsson-Wikmar, Helena Sackey, Karin Johansson","doi":"10.1177/15578585261419366","DOIUrl":"10.1177/15578585261419366","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis and treatment of breast cancer-related arm lymphedema (BCRAL) is essential to prevent progression. Local tissue water (LTW) can be assessed using the tissue dielectric constant (TDC), enabling detection before an increase of arm volume occurs. However, knowledge of the variation of LTW during cancer treatment and appropriate LTW thresholds for early detection of BCRAL is limited. The aim of this study was to examine differences in LTW between the arms, assess changes in LTW in each arm during adjuvant treatment, and calculate theoretical inter-arm thresholds for BCRAL.</p><p><strong>Method and results: </strong>This retrospective cohort study included 120 women treated with axillary lymph node dissection and radiotherapy. At 4-6 weeks post-surgery, LTW was significantly higher in the contralateral upper arm and the forearm at the lateral site compared to the ipsilateral arm. At 3-4 months post-radiotherapy, LTW remained higher in the contralateral upper arm at the lateral site and the forearm at the medial site. LTW decreased at the medial site of the ipsilateral upper arm and at the ventral site of the contralateral upper arm. Potential TDC ratio thresholds to detect BCRAL, including 3 SD, were calculated as 1.40 in the upper arm and 1.30 in the forearm.</p><p><strong>Conclusion: </strong>At both follow-ups, LTW was higher in the contralateral arm at specific sites compared to the ipsilateral arm and decreased at specific sites in both arms during oncological treatment. The calculated TDC thresholds may improve detection of BCRAL and enhance the interpretation of lymphedema status during oncological treatment.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"107-113"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Genetic Predisposition and Clinical Risk Factors for Breast Cancer-Related Lymphedema: Toward Personalized Prevention.","authors":"Rizky Ifandriani Putri, Noorwati Sutandyo, Nurjati Chairani Siregar, Septelia Inawati Wanandi, Kuntjoro Harimurti, Bethy S Hernowo, Bayu Brahma, Adhitya Bayu Perdana, Innas Widiasti, Erin Kurnia Sari, Sonar Soni Panigoro","doi":"10.1177/15578585261419377","DOIUrl":"https://doi.org/10.1177/15578585261419377","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer-related lymphedema (BCRL) remains a major chronic complication following axillary lymph node dissection (ALND), particularly in regions where locally advanced breast cancer is prevalent. While several clinical factors have been identified, the role of genetic predisposition in BCRL development remains underexplored. This study aimed to identify genetic and clinical factors associated with the development of BCRL, focusing on the Gap Junction Protein Alpha-4 (GJA4) rs705193 mutation as a potential biomarker.</p><p><strong>Methods: </strong>This prospective cohort study was conducted on 106 breast cancer patients who consecutively underwent ALND in Dharmais Cancer Hospital from October 2022 until October 2024. BCRL was assessed using indocyanine green (ICG) lymphography during a 12-month follow-up. Clinical data were obtained from medical records. The GJA4 rs705193 mutations were analyzed in DNA samples from peripheral blood using Sanger sequencing. A multivariate Cox regression was used to evaluate the association of GJA4 mutation and clinical factors with BCRL.</p><p><strong>Results: </strong>BCRL developed in 56 (52.8%) patients during follow-up. Subjects with BCRL exhibited a significantly higher body mass index (BMI) than those without BCRL (27.3 vs. 25.0 kg/m², <i>p</i> = 0.023). GJA4 mutations were identified in 40 (37.7%) patients, comprising 25 (44.6%) patients with BCRL and 15 (30.0%) patients without BCRL. The multivariate Cox regression analysis demonstrated that GJA4 mutation (HR = 1.73, 95% CI: 1.01-2.99, <i>p</i> = 0.047) and BMI (HR = 1.75; 95% CI: 1.02-3.02; <i>p</i> = 0.043) were significantly associated with an increased risk of BCRL.</p><p><strong>Conclusions: </strong>The GJA4 rs705193 mutations and elevated BMI independently increase the risk of BCRL in patients undergoing ALND. These findings enable the development of targeted preventive strategies for individuals at high risk.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261419377"},"PeriodicalIF":1.9,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}