{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:16:39Z","timestamp":1777922199186,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>surgery to treat breast cancer (BC) is associated with upper limb (UL) lymphedema, which in some cases may become permanent. It is uncertain whether lymphedema results from injury to either lymphatic or blood vessels, or to both.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      a cohort of 200 BC patients was examined 1, 3, 6, 12, and 24 months after surgery. Axillary and brachial blood vessels were evaluated using\n                      <jats:italic toggle=\"yes\">Doppler<\/jats:italic>\n                      Ultrasound, and patients had their UL examined for lymphedema at each visit. Patients who developed lymphedema 24 months after surgery presented with higher mean flow velocity (MFV) and end diastolic velocity (EDV) in both axillary (MFV\u2009=\u200913.57 vs. 10.7\u2009cm\/s,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02; EDV\u2009=\u20095.62 vs. 3.47\u2009cm\/s;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004) and brachial (MFV\u2009=\u200911.44 vs. 8.74\u2009cm\/s;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03; EDV\u2009=\u20095.08 vs. 3.04;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04) arteries as early as 1 month after surgery. Similar associations were found 3, 6, and 12 months after surgery. Early abnormalities of the resistive and pulsatility indexes were also significantly associated with persistent lymphedema. EDV measured 1 month after surgery had the best performance to detect patients who will later develop long-term lymphedema, (sensitivity\u2009=\u200973.7%; specificity\u2009=\u200971.2%; negative predictive value\u2009=\u200957.6%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>vascular abnormalities precede and are possible causal factors for UL lymphedema in BC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2021.0085","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T10:58:27Z","timestamp":1660215507000},"page":"118-129","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Blood Flow Abnormalities in Axillary and Brachial Arteries Precede the Onset of Persistent Lymphedema in Women Treated Surgically for Breast Cancer"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5162-8314","authenticated-orcid":false,"given":"Cintia","family":"Furlan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."},{"name":"Division of Gynecologic and Breast Oncology, Women's Hospital (CAISM), State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie F.M.","family":"Derchain","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."},{"name":"Division of Gynecologic and Breast Oncology, Women's Hospital (CAISM), State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Nascimben","family":"Matheus","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Einstein Integrated Colleges (FIEL), Limeira, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo Menezes","family":"Jales","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Imaging Sector, Women's Hospital (CAISM), State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds Ot\u00e1vio","family":"Sarian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."},{"name":"Division of Gynecologic and Breast Oncology, Women's Hospital (CAISM), State University of Campinas (Unicamp), Campinas, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13012"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2016.07.021"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000484223.07306.45"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-020-00961-4"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08923-7"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-020-01120-0"},{"key":"e_1_3_3_8_2","first-page":"2085","article-title":"Lymphedema in survivors of breast cancer (Review)","volume":"19","author":"He L","year":"2020","unstructured":"He L, , Qu H, , Wu Q, , Song Y. Lymphedema in survivors of breast cancer (Review). Oncol Lett, 2020; 19:2085\u20132096.","journal-title":"Oncol Lett"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1243-y"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-018-0830-3"},{"key":"e_1_3_3_11_2","first-page":"991","article-title":"Risk factors and prediction model for persistent breast-cancer-related lymphedema: A 5-year cohort study","volume":"27","author":"Penn IW","year":"2019","unstructured":"Penn IW, , Chang YC, , Chuang E, et al. Risk factors and prediction model for persistent breast-cancer-related lymphedema: A 5-year cohort study. Support Care Cancer, 2019; 27:991\u20131000.","journal-title":"Support Care Cancer"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2018.12.009"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-72032013000400007"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2017.02.008"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1590\/0100-69912015002004"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4835"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0959-8049(94)90539-8"},{"key":"e_1_3_3_18_2","first-page":"235","article-title":"Peripheral Vascular Ultrasound: How, Why and When, 2nd ed","author":"Thrush A","year":"2005","unstructured":"Thrush A, , Hartshorne T. Peripheral Vascular Ultrasound: How, Why and When, 2nd ed. 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