Lymphedema (LE) is a nasty souvenir of cancer treatment. Arm, leg, neck, or trunk swelling, pain, depression, and increased risk of cellulitis, a skin inflammation that can send you to the hospital, are all part of LE's devastating effects on cancer survivors. Typical treatment for LE is a life sentence of 24/7 compression garment wear, and sometimes instructions to use daily, at home, a machine that simulates massage to help remove stagnant arm or leg fluid. Often, these measures do not work, and LE patients are stuck with a permanently swollen, infection-prone arm or leg for the rest of their days. To make matters worse, medical insurance providers do not always pay for adequate compre...

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Lymphedema (LE) is a nasty souvenir of cancer treatment. Arm, leg, neck, or trunk swelling, pain, depression, and increased risk of cellulitis, a skin inflammation that can send you to the hospital, are all part of LE's devastating effects on cancer survivors. Typical treatment for LE is a life sentence of 24/7 compression garment wear, and sometimes instructions to use daily, at home, a machine that simulates massage to help remove stagnant arm or leg fluid. Often, these measures do not work, and LE patients are stuck with a permanently swollen, infection-prone arm or leg for the rest of their days. To make matters worse, medical insurance providers do not always pay for adequate compression garments or massage machines! Recently, microsurgeries that aim to improve lymph drainage out of swollen arms and legs in LE patients have been promoted by many surgeons in the US and other countries. The surgeries cost over $20,000, which most LE patients pay out-of-pocket, because insurance usually will not cover them. These surgeries sometimes decrease swelling, sometimes increase swelling, and sometimes do not change swelling. On average, swelling goes down by 30%, but remarkably, whether or not swelling improves, the risk of cellulitis goes down to nothing, and no one really knows why. We have the only imager in the world that can "see through your skin" to show whether or not lymph is pumping out of arms or legs. We propose to use this imager before and after these LE microsurgeries to prove whether or not we can show if they actually help move lymph out of swollen arms in breast cancer patients who have developed LE. We also want to pinpoint the molecules and cells responsible for cellulitis in LE patients--these players must disappear or stop working after LE microsurgeries. This work could guide LE microsurgeons to design the most effective procedures for eliminating cancer-related LE, and we will gain important insight into the way cellulitis works.

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