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J Appl Physiol (June 21, 2007). doi:10.1152/japplphysiol.00077.2007
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Submitted on January 16, 2007
Accepted on June 15, 2007

Upper Extremity Lymphatic Function at Rest and during Exercise in Breast Cancer Survivors with and without Lymphedema Compared to Healthy Controls

Kirstin N Lane1*, Lianne B Dolan2, Daniel Worsley3, and Donald C. McKenzie4

1 Medicine, University of British Columbia, Vancouver, Canada
2 Human Kinetics, University of British Columbia, Vancouver, Canada
3 Radiology, University of British Columbia, Vancouver, Canada
4 Human Kinetics, University of British Columbia, Vancouver, Canada; Medicine, University of British Columbia, Vancouver, Canada

* To whom correspondence should be addressed. E-mail: klane{at}interchange.ubc.ca.

Lymphoscintigraphy was used to measure lymphatic function at rest and during exercise in breast cancer survivors with lymphedema (BCRL, n=10), breast cancer survivors (BC, n=10), and controls (CONT, n=10). After injection of 99mTc-antimony colloid to the hands, subjects rested or performed 12 repeated sets of arm cranking for 2.5 min at 0.6 W.kg-1 followed by 2.5 min of rest. 1 min spot views were taken with a γ-radiation camera immediately post-injection and every 10 min for 60 min to calculate clearance rate (CR). As well, an upper body scan was taken at 65 min post-injection to measure radiopharmaceutical uptake in the axilla (AX) and forearm (FORE). All groups displayed similar increases in CR with exercise (p=0.000). AX significantly increased with exercise in CONT only (CONT: (mean ±SD) 4.9% ±2.6 vs. 7.9% ±4.2, p=0.000; BCRL: 1.4% ±1.2 vs. 1.7% ±2.1, p=0.531; BC: 3.9% ±3.4 vs. 5.2% ±3.2, p=0.130) while FORE, indicating dermal backflow, significantly increased in BCRL only (BCRL: 2.4 ±0.87 vs. 4.4 ±2.0, p=0.004; BC: 1.1% ±0.25 vs. 1.1% ±0.31, p=0.784; CONT: 0.93% ±0.26 vs. 1.0% ±0.20, p=0.296). The results indicate that in women with BCRL, exercise causes radiopharmaceuticals to clear from the hand at the same rate as BC and CONT, but instead of reaching the axilla, a greater amount of activity gets trapped in the dermis of the forearm. BC, meanwhile, have similar lymphatic function as CONT; however, there is a highly variable response which may suggest that some BC subjects may be at risk for developing lymphedema.







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