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Biomedical Optics Express

Biomedical Optics Express

  • Editor: Joseph A. Izatt
  • Vol. 1, Iss. 1 — Aug. 2, 2010
  • pp: 114–125

Direct evidence of lymphatic function improvement after advanced pneumatic compression device treatment of lymphedema

Kristen E. Adams, John C. Rasmussen, Chinmay Darne, I-Chih Tan, Melissa B. Aldrich, Milton V. Marshall, Caroline E. Fife, Erik A. Maus, Latisha A. Smith, Renie Guilloid, Sunday Hoy, and Eva M. Sevick-Muraca  »View Author Affiliations

Biomedical Optics Express, Vol. 1, Issue 1, pp. 114-125 (2010)

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Lymphedema affects up to 50% of all breast cancer survivors. Management with pneumatic compression devices (PCDs) is controversial, owing to the lack of methods to directly assess benefit. This pilot study employed an investigational, near-infrared (NIR) fluorescence imaging technique to evaluate lymphatic response to PCD therapy in normal control and breast cancer-related lymphedema (BCRL) subjects. Lymphatic propulsion rate, apparent lymph velocity, and lymphatic vessel recruitment were measured before, during, and after advanced PCD therapy. Lymphatic function improved in all control subjects and all asymptomatic arms of BCRL subjects. Lymphatic function improved in 4 of 6 BCRL affected arms, improvement defined as proximal movement of dye after therapy. NIR fluorescence lymphatic imaging may be useful to directly evaluate lymphatic response to therapy. These results suggest that PCDs can stimulate lymphatic function and may be an effective method to manage BCRL, warranting future clinical trials.

© 2010 OSA

OCIS Codes
(170.0110) Medical optics and biotechnology : Imaging systems
(170.2520) Medical optics and biotechnology : Fluorescence microscopy
(170.3880) Medical optics and biotechnology : Medical and biological imaging
(170.2655) Medical optics and biotechnology : Functional monitoring and imaging

ToC Category:
Diagnostic Applications

Original Manuscript: June 2, 2010
Revised Manuscript: July 8, 2010
Manuscript Accepted: July 8, 2010
Published: July 15, 2010

Virtual Issues
Bio-Optics in Clinical Application, Nanotechnology, and Drug Discovery (2010) Biomedical Optics Express
August 2, 2010 Spotlight on Optics

Kristen E. Adams, John C. Rasmussen, Chinmay Darne, I-Chih Tan, Melissa B. Aldrich, Milton V. Marshall, Caroline E. Fife, Erik A. Maus, Latisha A. Smith, Renie Guilloid, Sunday Hoy, and Eva M. Sevick-Muraca, "Direct evidence of lymphatic function improvement after advanced pneumatic compression device treatment of lymphedema," Biomed. Opt. Express 1, 114-125 (2010)

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  1. “Breast Cancer Facts & Figures,” A. C. Society, ed. (American Cancer Society, Inc., Atlanta, 2009–2010).
  2. J. M. Armer, “The problem of post-breast cancer lymphedema: impact and measurement issues,” Cancer Invest. 23(1), 76–83 (2005). [PubMed]
  3. E. J. Yang, W. B. Park, K. S. Seo, S. W. Kim, C. Y. Heo, and J. Y. Lim, “Longitudinal change of treatment-related upper limb dysfunction and its impact on late dysfunction in breast cancer survivors: a prospective cohort study,” J. Surg. Oncol. 101(1), 84–91 (2010). [CrossRef] [PubMed]
  4. T. M. Bennett Britton and A. D. Purushotham, “Understanding breast cancer-related lymphoedema,” Surgeon 7(2), 120–124 (2009). [CrossRef] [PubMed]
  5. S. A. Khan, “Axillary reverse mapping to prevent lymphedema after breast cancer surgery: defining the limits of the concept,” J. Clin. Oncol. 27(33), 5494–5496 (2009). [CrossRef] [PubMed]
  6. S. A. McLaughlin, M. J. Wright, K. T. Morris, G. L. Giron, M. R. Sampson, J. P. Brockway, K. E. Hurley, E. R. Riedel, and K. J. Van Zee, “Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements,” J. Clin. Oncol. 26(32), 5213–5219 (2008). [CrossRef] [PubMed]
  7. R. Ponzone, N. T. Cont, F. Maggiorotto, E. Cassina, P. Mininanni, N. Biglia, and P. Sismondi, “Extensive nodal disease may impair axillary reverse mapping in patients with breast cancer,” J. Clin. Oncol. 27(33), 5547–5551 (2009). [CrossRef] [PubMed]
  8. P. A. Morgan, P. J. Franks, and C. J. Moffatt, “Health-related quality of life with lymphoedema: a review of the literature,” Int Wound J 2(1), 47–62 (2005). [CrossRef] [PubMed]
  9. International Society of Lymphology, “The diagnosis and treatment of peripheral lymphedema. 2009 Concensus Document of the International Society of Lymphology,” Lymphology 42(2), 51–60 (2009). [PubMed]
  10. D. S. Ko, R. Lerner, G. Klose, and A. B. Cosimi, “Effective treatment of lymphedema of the extremities,” Arch. Surg. 133(4), 452–458 (1998). [CrossRef] [PubMed]
  11. M. Boris, S. Weindorf, and S. Lasinkski, “Persistence of lymphedema reduction after noninvasive complex lymphedema therapy,” Oncology 11, 99–109; discussion 110, 113–104 (1997).
  12. M. Boris, S. Weindorf, B. Lasinski, and G. Boris, “Lymphedema reduction by noninvasive complex lymphedema therapy,” Oncology (Huntingt.) 8(9), 95–106, discussion 109–110 (1994) (Williston Park). [PubMed]
  13. J. R. Casley-Smith, M. Foldi, T. J. Ryan, and e. al., “Summary of the 10th International Congress of Lymphology Working Group Discussions and Recommendations,” in Lymphology(Adelaide, Australia, 1985), pp. 175–180.
  14. I. Forner-Cordero, J. Munoz-Langa, A. Forner-Cordero, and J. M. Demiguel-Jimeno, “Predictive Factors of Response to Decongestive Therapy in Patients with Breast-Cancer-Related Lymphedema,” Ann Surg Oncol (2009).
  15. H. N. Mayrovitz, “Interface pressures produced by two different types of lymphedema therapy devices,” Phys. Ther. 87(10), 1379–1388 (2007). [PubMed]
  16. “Medicare Advantage Medical Policy Bulletin,” (https:// www.msbcbs.com/medadvpolicy/printerfriendly/E-7-004.html ).
  17. “Article for Pneumatic Compression Devices - Policy Article - Effective January 2009,” (Noridian Medicare, 2009), Accessed 01/01, 2009.
  18. J. C. Rasmussen, I. C. Tan, M. V. Marshall, C. E. Fife, and E. M. Sevick-Muraca, “Lymphatic imaging in humans with near-infrared fluorescence,” Curr. Opin. Biotechnol. 20(1), 74–82 (2009). [CrossRef] [PubMed]
  19. E. M. Sevick-Muraca and J. C. Rasmussen, “Molecular imaging with optics: primer and case for near-infrared fluorescence techniques in personalized medicine,” J. Biomed. Opt. 13(4), 041303 (2008). [CrossRef] [PubMed]
  20. E. M. Sevick-Muraca, R. Sharma, J. C. Rasmussen, M. V. Marshall, J. A. Wendt, H. Q. Pham, E. Bonefas, J. P. Houston, L. Sampath, K. E. Adams, D. K. Blanchard, R. E. Fisher, S. B. Chiang, R. Elledge, and M. E. Mawad, “Imaging of lymph flow in breast cancer patients after microdose administration of a near-infrared fluorophore: feasibility study,” Radiology 246(3), 734–741 (2008). [CrossRef] [PubMed]
  21. J. C. Rasmussen, I.-C. Tan, M. V. Marshall, K. E. Adams, S. Kwon, C. E. Fife, E. A. Maus, L. A. Smith, K. R. Covington, and E. M. Sevick-Muraca, “Human lymphatic arcitecture and transport imaged using near-infrared fluorescence (Part I),”submitted.
  22. “Flexitouch,” (Tactile Systems Technology, Inc., 2010), http://www.tactilesystems.com/flexitouch/details.html , Accessed February 15, 2010.
  23. S. M. Schonholz, “Preoperative assessment enables the early detection and successful treatment of lymphedema,” Cancer 115(4), 909, author reply 909–910 (2009). [CrossRef] [PubMed]
  24. N. L. Stout Gergich, L. A. Pfalzer, C. McGarvey, B. Springer, L. H. Gerber, and P. Soballe, “Preoperative assessment enables the early diagnosis and successful treatment of lymphedema,” Cancer 112(12), 2809–2819 (2008). [CrossRef] [PubMed]
  25. R. J. Damstra, H. G. Voesten, W. D. van Schelven, and B. van der Lei, “Lymphatic venous anastomosis (LVA) for treatment of secondary arm lymphedema. A prospective study of 11 LVA procedures in 10 patients with breast cancer related lymphedema and a critical review of the literature,” Breast Cancer Res. Treat. 113(2), 199–206 (2009). [CrossRef] [PubMed]
  26. S. H. Ridner, E. McMahon, M. S. Dietrich, and S. Hoy, “Home-based lymphedema treatment in patients with cancer-related lymphedema or noncancer-related lymphedema,” Oncol. Nurs. Forum 35(4), 671–680 (2008). [CrossRef] [PubMed]
  27. K. H. Schmitz, R. L. Ahmed, A. Troxel, A. Cheville, R. Smith, L. Lewis-Grant, C. J. Bryan, C. T. Williams-Smith, and Q. P. Greene, “Weight lifting in women with breast-cancer-related lymphedema,” N. Engl. J. Med. 361(7), 664–673 (2009). [CrossRef] [PubMed]
  28. I.-C. Tan, E. A. Maus, J. C. Rasmussen, M. V. Marshall, K. E. Adams, C. E. Fife, L. A. Smith, and E. M. Sevick-Muraca, “Assessment of improved lymphatic propulsion and transport following manual lymphatic drainage using NIR fluorescent imaging (Part II),” submitted.
  29. O. Wilburn, P. Wilburn, and S. G. Rockson, “A pilot, prospective evaluation of a novel alternative for maintenance therapy of breast cancer-associated lymphedema [ISRCTN76522412],” BMC Cancer 6(1), 84 (2006). [CrossRef] [PubMed]
  30. M. Torres Lacomba, M. J. Yuste Sánchez, A. Zapico Goñi, D. Prieto Merino, O. Mayoral del Moral, E. Cerezo Téllez, and E. Minayo Mogollón, “Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial,” BMJ 340(jan12 1), b5396 (2010). [CrossRef] [PubMed]
  31. M. V. Marshall, J. C. Rasmussen, I. C. Tan, M. B. Aldrich, K. E. Adams, X. Wang, C. E. Fife, E. A. Maus, L. A. Smith, and E. M. Sevick-Muraca, “Near-infrared fluorescence imaging in humans with indocyanine green: a review and update,” The Open Surgical Oncology Journal 2(2), 12–25 (2010). [CrossRef]

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