Navigating Lymphedema: The Impact of Indocyanine Green Lymphography on Personalized Therapy Outcomes in Breast Cancer Patients.

Aim: To evaluate the role of Indocyanine Green Lymphography (ICG_L) in the early diagnosis and personalized management of breast cancer-related lymphedema (BCRL) among high-risk breast cancer (BC) survivors.

Methods: Patients who admitted to the UPMC Magee-Womens Hospital Lymphedema Program between October 2018 and December 2021 with episodic symptoms were enrolled into the study. Patient demographics, clinical characteristics, and outcomes were prospectively collected and retrospectively analysed. Lymphatic flow disruptions were identified and guided personalized therapeutic interventions were guided by ICG_L.

Results: Among 154 BC survivors, 184 arms were evaluated. Initial ICG_L showed 57.1% had no lymphedema, while 42.9% were classified as stage 1 to 3 lymphedema. Early diagnosis and personalized interventions provided improved outcomes, with only 4.3% developing clinical lymphedema after a median follow-up of 27 months. Patients exhibited stable or improved symptoms with individualized treatments such as manual lymphatic drainage, compression therapies, and physiotherapy.

Conclusion: ICG_L evaluation is essential for patients at high-risk of developing BCRL. Early diagnosis before clinical onset of lymphedema, and ICG_L guided therapy significantly enhances the clinical outcomes and improves lymphedema management.