WP 2.9: ICG-BREAST-LYMPH. Breast cancer related lymphedema (BCRL) and breast reconstruction. An Inter-Regional Observational Study

Surgical treatment for breast cancer may be performed as breast conserving therapy, mastectomy with or without reconstruction, axillary lymph node dissection (sentinel node or relevant axillary dissection). These treatments have increased the overall survival for women treated for BC. However, BC treatment modalities may leave the patient with a missing breast (distorted body-image) and as a late-effect in addition lymphedema, in some patients significantly decreases their quality of life. Indocyanine green angiography has been shown to optimize breast reconstructive procedures. In addition, Indocyanine green lymphangiography has become the mainstay of identification of lymphatic drainage pathway. Thus, applying these two techniques may significantly improve the breast reconstruction with autologous tissue and alleviate one of the late effects of breast cancer treatment i.e., lymphedema.
The study will assess the use of indocyanine-green-imaging in breast reconstruction after mastectomy as well as surgical treatment of lymphedema, when conservative treatment fails. The patient reported outcome measures and quality of life will be assessed using the validated Breast-Q and Lymph-Q questionnaires.
Should the results of this observational study yield favorable results for breast-cancer-related lymphedema and breast reconstruction, we may consider implementing VLNT+/- LVA and indocyanine green imaging as standard of care for the Danish patients. Moreover, the results from the present study – if favorable – may potentially also benefit patients suffering from lymphedema caused by treatment of other types of cancers than BC. Finally, this study represents repurposing of the ICG-technique.

Awarded to: Jens Ahm Sørensen (Odense Universitets Hospital) – CFA2

Awarded grant to support VIP personnel.