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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2020

01-06-2020 | Breast Cancer | Clinical trial

Assessing breast lymphoedema following breast cancer treatment using indocyanine green lymphography

Authors: Asha Heydon-White, Hiroo Suami, John Boyages, Louise Koelmeyer, Karen C. Peebles

Published in: Breast Cancer Research and Treatment | Issue 3/2020

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Abstract

Purpose

Breast lymphoedema is a largely unrecognised survivorship issue for women following breast cancer treatment. While a few objective methods have previously been applied to assess breast lymphoedema, none are capable of imaging breast lymphatics or identifying lymphatic morphological changes indicative of breast lymphoedema. The purpose of this study was to determine if indocyanine green (ICG) lymphography, a validated assessment technique in breast cancer-related lymphoedema), can visualise breast lymphatics and identify breast lymphoedema. Additionally, ICG lymphography was utilised to investigate lymphatic drainage pathways of the affected breast following breast-conserving therapy.

Methods

Twenty female participants (10 breast lymphoedema and 10 healthy controls) were recruited for this pilot study. All underwent a medical history, physical breast assessment, tissue dielectric constant measures of breast water content, and ICG lymphography.

Results

ICG lymphography identified lymphatic morphological changes in all breast lymphoedema participants (dermal backflow patterns = 10, collateral lymphatic drainage = 9) and none in the control group. The dominant lymphatic drainage pathway to the ipsilateral axilla was observed in all control participants but in only four breast lymphoedema participants. Collateral drainage pathways in the breast lymphoedema group were to: parasternal (6/10); contralateral axilla (4/10); intercostal (3/10); and clavicular (2/10) regions.

Conclusion

These 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.
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Metadata
Title
Assessing breast lymphoedema following breast cancer treatment using indocyanine green lymphography
Authors
Asha Heydon-White
Hiroo Suami
John Boyages
Louise Koelmeyer
Karen C. Peebles
Publication date
01-06-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05661-y

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