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Early Diagnosis of Breast Cancer-related Lymphedema

Recruiting
Conditions
Lymphedema
Interventions
Diagnostic Test: lymphoscintigraphy
Diagnostic Test: circumference measurement
Diagnostic Test: sonography
Diagnostic Test: DXA body composition analysis
Registration Number
NCT06046365
Lead Sponsor
Kaohsiung Veterans General Hospital.
Brief Summary

This study will conduct clinical trials to explore the mechanisms behind the development of upper limb lymphedema following breast cancer surgery. The investigators will recruit patients who have undergone breast cancer surgery and utilize Indocyanine Green (ICG) lymphography and Lymphoscintigraphy to identify the locations of lymphatic blockages. Shear Wave Elastography (SWE) will be used to detect changes in tissue limb compliance. DXA body composition analysis will measure the differences in the composition ratios between edematous and normal limbs. In addition, diffusion correlation spectrometry will be employed to monitor changes in deep tissue blood flow, complemented by continuous measurements of limb circumference and other physiological parameters. The study aims to explore the interrelationships among lymphatic circulation, limb circumference, tissue compliance, and tissue blood flow rates.

Detailed Description

Breast cancer ranks as the most common cancer among women in Taiwan. According to the cancer registry data of Taiwan's Ministry of Health and Welfare, there were 16,325 new cases of breast cancer in 2016. Approximately one in 12 women will develop breast cancer in her lifetime. Although the incidence rate is high, the survival rate after clinical treatment is also quite high. The five-year survival rate for early-stage breast cancer patients exceeds 90%, making it a highly manageable disease at present.

The incidence rate of breast cancer-related lymphedema is around 21.4%, and is expected to become increasingly common as the survival rate of patients improves. Aside from causing psychological distress, it also impairs a patient's work and daily life capabilities. Patients also have to bear additional medical expenses, which brings a significant financial burden to families. Current research supports that early detection and treatment are key to controlling breast cancer-related lymphedema. However, there is still a need for a clearer understanding of the risk factors causing lymphedema and the physiological changes that occur when it manifests, in order to achieve the goal of early detection.

This study will conduct clinical trials to investigate the mechanisms of upper limb lymphedema after breast cancer surgery. The investigators will recruit post-operative breast cancer patients and use Indocyanine Green (ICG) lymphography and Lymphoscintigraphy to detect lymphatic blockage locations; Shear Wave Elastography (SWE) to detect changes in tissue limb compliance; DXA body composition analysis to measure the differences in edema and normal limb composition ratios; and diffusion correlation spectrometry to measure deep tissue blood flow changes, along with continuous measurements of limb circumference and other physiological parameters. The study aims to explore the interrelationship among lymphatic circulation, limb circumference, tissue compliance, and tissue blood flow.

The expected results of this study can help the investigators understand the risk factors causing lymphedema and the physiological changes that occur when it manifests, overcome the current difficulties in early lymphedema detection, and develop effective monitoring methods and equipment. This will provide more possibilities for the early detection and treatment of future patients with breast cancer-related lymphedema.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
100
Inclusion Criteria
  • Female patients who are expected to undergo breast cancer resection surgery or have already undergone breast resection surgery for breast cancer.
  • Absence of unhealed open wounds or other conditions unsuitable for tactile measurements within the measurement area.
  • No severe cognitive or emotional impairments.
  • No substance abuse (alcohol or drugs).
  • Females aged between 20 and 80, capable of fully complying with the requirements of this study plan.
Exclusion Criteria
  • Presence of unhealed open wounds or other conditions unsuitable for tactile measurements within the measurement area.
  • Upper limb abnormalities in function (including joint mobility and muscle strength).
  • Significant cognitive, auditory, or expressive language issues that hinder comprehension and compliance with instructions.
  • Lack of assistance for daily measurements.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
mastectomylymphoscintigraphyExpected to include female patients who are undergoing breast cancer resection surgery or those who have already undergone breast resection surgery for breast cancer.
mastectomysonographyExpected to include female patients who are undergoing breast cancer resection surgery or those who have already undergone breast resection surgery for breast cancer.
mastectomycircumference measurementExpected to include female patients who are undergoing breast cancer resection surgery or those who have already undergone breast resection surgery for breast cancer.
mastectomyDXA body composition analysisExpected to include female patients who are undergoing breast cancer resection surgery or those who have already undergone breast resection surgery for breast cancer.
Primary Outcome Measures
NameTimeMethod
circumferenceeveryday, through study completion, an average of 1 year

Circumference measurements are taken and recorded at 2 cm intervals from the wrist crease to the armpit on both upper limbs

DXA body composition analysisOnce at the beginning of the study, and another assessment will be conducted 3 months later if there is a deterioration in lymphedema

Using DXA to detect and compare the composition of both limbs at different stages after the onset of lymphedema, including changes in protein, fat, and mineral density

Tissue complianceevery 1 week, through study completion, an average of 1 year

Measurements are taken every 5 cm from the wrist crease to the armpit on both upper limbs using ShearWave Elastography

LymphoscintigraphyOnce at the beginning of the study, and another assessment will be conducted six months later if there is a deterioration in lymphedema

Golden Standard for diagnosing lymphedema, used for detecting the location of lymphatic circulation blockage

Indocyanine green (ICG) lymphographyOnce at the beginning of the study, and another assessment will be conducted 3 months later if there is a deterioration in lymphedema

Routine examination, used for detecting the type of lymphatic blockage

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Kaohsiung Veterans General Hospital

🇨🇳

Kaohsiung, Taiwan

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