Global abnormalities in lymphatic function following systemic therapy in patients with breast cancer

Bains, Salena; Peters, A. M.; Zammit, Charles; Ryan, Nicola; Ballinger, James R.; Glass, D.; Allen, Sarah; Stanton, A.W.B.; Mortimer, Peter; Purushotham, Arnie

doi:10.1002/bjs.9766

Cited by 19 publications

(13 citation statements)

References 22 publications

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“…Adjuvant radiotherapy and systemic therapy have also shown a correlation with the development of BCRL. A few studies have reported an association between BCRL and adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Adjuvant taxanes and the development of breast cancer-related arm lymphoedema

Cariati

Bains

Grootendorst

et al. 2015

British Journal of Surgery

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“…Adjuvant radiotherapy and systemic therapy have also shown a correlation with the development of BCRL. A few studies have reported an association between BCRL and adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…This observation is in line with the data reported here and supports a key role of taxanes in the pathogenesis of BCRL. Taxanes may cause systemic disruption, which could have a longer‐term effect on lymphatic function.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant taxanes and the development of breast cancer-related arm lymphoedema

Cariati

Bains

Grootendorst

et al. 2015

British Journal of Surgery

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“…Recent studies have also identified polymorphisms in multiple candidate genes that appear to be associated with the development of BCRL [ 36 , 37 ]. Bains et al [ 38 ] also reported abnormal lower limb lymphoscintigraphy in two thirds of the women who had developed upper limb BCRL and in half of the women who had no BCRL, suggesting an unidentified association between breast cancer and lymphatic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Use of lymphoscintigraphy to differentiate primary versus secondary lower extremity lymphedema after surgical lymphadenectomy: a retrospective analysis

et al. 2018

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BackgroundWhen managing patients with cancer, lymphedema of the lower limbs (LLL) is commonly reported as secondary to the surgical excision and/or irradiation of lymph nodes (LNs). In the framework of lymphoscintigraphic imaging performed to evaluate secondary LLL, some lympho-nodal presentations have been observed that could not be explained by the applied treatments, suggesting that these LLL might be primary. Therefore, all our lymphoscintigraphic examinations that were performed in patients for LLL after surgery for gynecological or urological cancer were retrospectively analyzed in order to evaluate the frequency in which these LLL might not be secondary (either completely or partially) but primary in origin.MethodsLymphoscintigraphies performed in 33 patients who underwent LN dissection (limited to the intra-abdominal LN) with or without radiotherapy for histologically confirmed ovarian cancer (n = 6), uterine cancer (n = 14 with cervical cancer and n = 7 with endometrial cancer), or prostate cancer (n = 6) were compared to lymphoscintigraphies obtained in primary LLL.ResultsIn 12 (33% of the) patients (3 men plus 9 women, 4 with cervical cancer and 5 with endometrial cancer), scintigraphy of the lower limbs revealed lympho-nodal presentation that did not match with the expected consequences of the surgical and/or radiological treatments and were either suggestive or typical of primary lymphedema.ConclusionsThis retrospective analysis of a limited but well-defined series of patients suggests that the appearance of LLL might not be related to cancer treatment(s) but that these LLL may represent the development of a primary lymphatic disease latent prior to the therapeutic interventions.

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“…Interestingly, one study using near-infrared fluorescent imaging (NIRFLI) found lymphatic architecture abnormalities in both the affected and normal arm in patients with unilateral BCRL, and the percentage of aberrant lymphatics increased with time after initial onset of LE, suggesting that the inflammatory response in LE is systemic. [35][36][37][38][39] Supporting this finding, in a murine model of acute inflammation, systemic lymph propulsive frequency (pumping) and velocity measured using NIRFLI dramatically decreased after a lipopolysaccharide (LPS)-mediated inflammatory insult, before gradually returning to normal values after several days. Changes were not only local, [40][41][42] but systemic (i.e., occurring on both sides of the mouse), despite inflammatory insult on only one side.…”

Section: Systemic Inflammatory Responsementioning

confidence: 96%

New and Emerging Treatments for Lymphedema

Schaverien

Aldrich

2018

Seminars in Plastic Surgery

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Although nonoperative and operative treatments for lymphedema (LE) are well established, these procedures typically provide only partial relief from limb swelling, functional impairment, and the risk of cellulitis. The lack of a cure for LE, however, is due to an incomplete understanding of the underlying pathophysiological mechanisms, and current research efforts are focusing on elucidating these processes to provide new, targeted therapies for this prevalent disease for which there is no cure. This article reviews the current literature regarding the pathophysiological mechanisms that underlie LE, as well as new and emerging therapies for the condition.

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Global abnormalities in lymphatic function following systemic therapy in patients with breast cancer

Abstract: ISRCTN84866416 ( http://www.isrctn.com).

Cited by 19 publications

References 22 publications

Adjuvant taxanes and the development of breast cancer-related arm lymphoedema

Adjuvant taxanes and the development of breast cancer-related arm lymphoedema

Use of lymphoscintigraphy to differentiate primary versus secondary lower extremity lymphedema after surgical lymphadenectomy: a retrospective analysis

New and Emerging Treatments for Lymphedema

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