Normal lymphoscintigraphy values to unravel breast cancer lymphoedema
Research type
Research Study
Full title
Establishing normal lymphoscintigraphy values to unravel breast cancer related lymphoedema
IRAS ID
225017
Contact name
Petros Charalampoudis
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Breast cancer related lymphoedema is a swelling of the arm that presents following axillary lymph node surgery. It is an irreversible side effect of treatment, that affects 1 out of 4 patients undergoing axillary clearance and 1 out of 20 undergoing sentinel lymph node biopsy. It is associated with significant physical, functional, psychological and social morbidity requiring lifelong management.
Despite its prevalence, breast cancer related lymphoedema remains a poorly understood process and it remains unclear why some patients develop the condition and others do not.
We recently suggested that lymphatic weakness (‘latent lymphoedema’) may predispose women to breast cancer related lymphoedema. Studying lower limbs of women more than 3 years post-axillary treatment, we found that lymphatic function was decreased in women who have developed breast cancer related lymphoedema compared with those who had not.
Lymphoscintigraphy with subcutaneous Tc-99m-nanocolloid is currently the preferred method for assessing lymphatic function in limb swelling of unknown cause. Despite its widespread use, lymphoscintigraphic protocols vary greatly both in clinical practice and in the scientific literature. Some include exercise as a ‘stress’ for lymphatics; the timing of image capture also varies across centres. This renders lymphoscintigraphic results difficult to compare and their accuracy questionable.
We recently described a novel approach of lymphoscintigraphic quantification which was found to improve the detection rate of abnormal lymphatic function in clinically swollen limbs by over 30%.
This study was however conducted in a cohort of patients with clinically abnormal limbs, and therefore normal values remain to be established.Once an accurate range of normal is identified, this technique could provide the opportunity to assess lymphatic function and potentially identify latent lymphoedema in breast cancer patients prior to the onset of swelling.
We are planning to conduct this study in healthy volunteers to help us understand the normal standards of lymph drainage in the healthy lower limb.
REC name
London - Chelsea Research Ethics Committee
REC reference
17/LO/0624
Date of REC Opinion
21 Apr 2017
REC opinion
Favourable Opinion