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Constitutively Enhanced Lymphatic Pumping in the Upper Limbs of Women Who Later Develop Breast Cancer-Related Lymphedema.

Cintolesi, V; Stanton, AW; Bains, SK; Cousins, E; Peters, AM; Purushotham, AD; Levick, JR; Mortimer, PS (2016) Constitutively Enhanced Lymphatic Pumping in the Upper Limbs of Women Who Later Develop Breast Cancer-Related Lymphedema. Lymphatic Research and Biology, 14 (2). pp. 50-61. ISSN 1557-8585 https://doi.org/10.1089/lrb.2016.0005
SGUL Authors: Mortimer, Peter Sydney Levick, John Rodney Cousins, Emma Claire

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Abstract

BACKGROUND: It has previously been shown that the lymph drainage rate in both upper limbs is greater in women destined to develop breast cancer-related lymphedema (BCRL) than in those who do not develop BCRL, indicating a constitutive predisposition. We explored constitutive differences further by measuring the maximum lymphatic pump pressure (Ppump) and the rate of (99m)Tc-Nanocoll transport generated by the contractile upper limb lymphatics before and after breast cancer surgery in a group of women who were followed for 2 years to determine their eventual BCRL or non-BCRL status. METHODS AND RESULTS: Ppump and tracer transport rate were measured by lymphatic congestion lymphoscintigraphy in the ipsilateral upper limb in 26 women pre- and post-breast cancer surgery. BCRL occurred in 10/26 (38.5%) cases. Ppump in the women who later developed BCRL (40.0 ± 8.2 mmHg) was 1.7-fold higher than in those who did not develop BCRL (23.1 ± 10.8 mmHg, p = 0.001). Moreover, the rate of lymph tracer transport into the forearm was 2.2-fold greater in the women who later developed BCRL (p = 0.052). Surgery did not significantly reduce Ppump measured 21 weeks postsurgery, but impaired forearm tracer transport in pre-BCRL women by 58% (p = 0.047), although not in those who did not develop BCRL. CONCLUSIONS: Women destined to develop BCRL have higher pumping pressures and lymph transport, indicating harder-working lymphatics before cancer treatment. Axillary lymphatic damage from surgery appears to compromise lymph drainage in those women constitutively predisposed to higher lymphatic pressures and lymph transport.

Item Type: Article
Additional Information: Must not be used for commercial purposes. Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/lrb.2016.0005
Keywords: Oncology & Carcinogenesis, 1107 Immunology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Innovation & Development in Education (INMEID)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cell Sciences (INCCCS)
Journal or Publication Title: Lymphatic Research and Biology
ISSN: 1557-8585
Language: eng
Dates:
DateEvent
1 June 2016Published
Publisher License: Publisher's own licence
PubMed ID: 27309032
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107983
Publisher's version: https://doi.org/10.1089/lrb.2016.0005

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