Vascularized Lymph Node Transfer for Patients with Breast Cancer-Related Lymphedema Can Potentially Reduce the Burden of Ongoing Conservative Management.

Vascularized lymph node transfer (VLNT) microsurgery is conducted in selected specialist lymphatic programs as a surgical treatment option for breast cancer-related lymphedema (BCRL) with variation in treatment outcomes. Ten patients with BCRL underwent VLNT from 2012 to 2015. Donor sites were the inguinal ( = 6) or supraclavicular fossa/neck ( = 4) regions and recipient sites were the axilla ( = 6) or elbow regions ( = 4).

A new indocyanine green fluorescence lymphography protocol for identification of the lymphatic drainage pathway for patients with breast cancer-related lymphoedema.

Background: Breast cancer related lymphoedema (BCRL) is a common side effect of cancer treatment. Recently indocyanine green (ICG) fluorescent lymphography has become a popular method for imaging the lymphatics, however there are no standard protocols nor imaging criteria. We have developed a prospective protocol to aid in the diagnosis and therapeutic management of BCRL.

Reliability and Validity of Measurement Tools for Residual Limb Volume in People With Limb Amputations: A Systematic Review.

Background: Measurements of residual limb volume often guide decisions on the type and timing of prosthetic prescription. To help inform these decisions, it is important that clinicians use measurement tools that are reliable and valid.

Purpose: The aim of this systematic review was to investigate the reliability and validity of measurement tools for residual limb volume in people with limb amputations.

Estimation of Arm Adipose Tissue Quotient Using Segmental Bioimpedance Spectroscopy.

Background: Breast cancer-related lymphedema (BCRL) is a chronic condition characterized by accumulation of lymph fluid that may subsequently become fibrotic with infiltration of adipose tissue. Bioimpedance spectroscopy (BIS) is the preferred method for early detection of lymphedema as it can estimate extracellular lymph fluid. This study developed a modified impedance technique that concurrently estimates both lymph accumulation and increases in adipose tissue.

Does Lymphedema Severity Affect Quality of Life? Simple Question. Challenging Answers.

Purpose: Lymphedema can have a negative impact on the function and quality of life (QOL) of patients, but most studies have examined lymphedema as a binary variable, rather than a multidimensional disease that ranges in severity. This study explored the potential impact of lymphedema severity on function and overall QOL.

Methods And Results: Of the 54 lymphedema patients recruited, 40 reported their most severe swelling to be in a limb.

Breast Cancer-Related Arm Lymphedema: Fluctuation over Six Months and the Effect of the Weather.

Background: An understanding of normal fluctuation of lymphedema over time is important to identify real change, whether it is from response to treatment or worsening of the condition. The weather is another factor that possibly influences lymphedema but has had minimal investigation to date. The purpose of this study was to determine the extent to which breast cancer-related lymphedema (BCRL) fluctuated over a 6-month period and the influence of temperature, humidity, and barometric pressure.

Assessment of segmental arm soft tissue composition in breast cancer-related lymphedema: a pilot study using dual energy X-ray absorptiometry and bioimpedance spectroscopy.

Background: Changes in arm soft tissue composition, especially increased adipose tissue, has been found in advanced, non-pitting breast cancer-related lymphedema (BCRL). The aim of this study was to examine whether these changes were localized to any particular region of the arm and whether they occurred in lymphedema which still pitted to pressure. Secondary aims were to explore relationships between arm segment volumes, bioimpedance spectroscopy (BIS) measurements of extracellular fluid (ECF), and dual-energy X-ray absorptiometry (DXA) measurements of tissue composition.

Assessment of breast cancer-related lymphedema: a comparison of moisture meter and spot bioimpedance measurement.

Background: Tissue dielectric constant (TDC) and spot bioimpedance measurement (BIA) have a role in the assessment of tissue composition changes in breast cancer-related lymphedema (BCRL). Our aims were to determine whether TDC and spot BIA measures could detect inter-limb differences in BCRL, explore the relationship between methods, and establish the intra-rater reliability and technical error of measurement for TDC.

Methods And Results: Women with (n=20) and without (n=4) unilateral BCRL participated.

Reliability and concurrent validity of the perometer for measuring hand volume in women with and without lymphedema.

Background: Lymphedema of hand after breast cancer treatment causes significant loss of hand function. Although there are several ways of assessing limb volume, measuring hand volume has been problematic due to technical difficulties associated with assessment of finger volumes. The aim of this study was to investigate the criterion validity and reliability of Perometer™ for measuring hand volume in woman with and without lymphedema.

Assessment of bilateral limb lymphedema by bioelectrical impedance spectroscopy.

Objective: The aim of the present study was to determine if the ratio of extracellular fluid (ECF), including the lymph, to that of intracellular fluid (ICF), as measured by bioimpedance spectroscopy (BIS), could be used to assess bilateral lymphedema (LE).

Background: The presence of LE is commonly determined as an increase in tissue volume due to the presence of excess lymph relative to the volume of a comparable unaffected body region or to comparative normative data. However, in bilateral LE of the limbs, a comparable body region, the contralateral limb, is also affected, precluding normalization.

Segmental measurement of breast cancer-related arm lymphoedema using perometry and bioimpedance spectroscopy.

Purpose: To determine if bioimpedance spectroscopy (BIS) could detect localised lymphoedema of the arm and to compare BIS measurements with equivalent measures of limb volume by perometry.

Methods: Women with mild to severe upper limb lymphoedema (n = 29) and women with no history of lymphoedema (n = 11) participated. Commencing at the ulnar styloid of the wrist, 4 × 10 cm segment measurements were made of each arm using both BIS and perometry.

Operational equivalence of bioimpedance indices and perometry for the assessment of unilateral arm lymphedema.

Background: The aim was to assess the agreement between bioimpedance indices and inter-limb volume differences, as assessed by perometry, for assessment of unilateral arm lymphedema.

Methods: Impedance was measured in the arms of 45 women with lymphedema and a separate control group without lymphedema (n = 21). Arm volume was measured at the same time by perometry.

A profile of physiotherapy clinical education.

The purpose of the study was to examine clinical education placement data to generate a profile of providers and examine the students' exposure to health care and educational factors during clinical education. A retrospective audit of clinical placement rosters was undertaken for 3 calendar years (2001-2003). Data were analysed overall and by clinical school for sites and placements, public or private sector and type of placement.