Clinico-Functional Correlation of Upper Extremity Lymphedema Severity in Patients with Breast Cancer

PURPOSE: To examine the association between clinical severity and lymphatic function of breast cancer-related lymphedema. METHODS AND RESULTS: 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. CONCLUSION: In patients with upper-extremity lymphedema, superficial lymphatic function had a significant correlation with subcutaneous edema and extracellular fluid accumulation.