{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:21:52Z","timestamp":1781767312894,"version":"3.54.5"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Agency for Innovation by Science and Technology","award":["IWT 60519"],"award-info":[{"award-number":["IWT 60519"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The objective of this trial was to investigate the effectiveness of fluoroscopy-guided manual lymph drainage (MLD), as part of decongestive lymphatic therapy (DLT), on the superficial lymphatic architecture in patients with chronic mild to moderate breast cancer-related lymphoedema (BCRL). This trial was a multicentre, double-blind, randomised controlled trial involving 194 participants with BCRL. Participants were randomised into (1) DLT with fluoroscopy-guided MLD (intervention group), (2) DLT with traditional MLD (control group), or (3) DLT with placebo MLD (placebo group). Superficial lymphatic architecture was evaluated as a secondary outcome, visualised by ICG lymphofluoroscopy at the baseline (B0), post-intensive (P), and post-maintenance phases (P6). Variables were (1) number of efferent superficial lymphatic vessels leaving the dermal backflow region, (2) total dermal backflow score, and (3) number of superficial lymph nodes. The traditional MLD group showed a significant decrease in the number of efferent superficial lymphatic vessels at P (p = 0.026), and of the total dermal backflow score at P6 (p = 0.042). The fluoroscopy-guided MLD and placebo group showed significant decreases in the total dermal backflow score at P (p &lt; 0.001 and p = 0.044, respectively) and at P6 (p &lt; 0.001 and p = 0.007, respectively); the placebo MLD group showed a significant decrease in the total number of lymph nodes at P (p = 0.008). However, there were no significant between-group differences for the changes in these variables. In conclusion, based on lymphatic architecture outcomes, the added value of MLD, in addition to the other parts of DLT, could not be demonstrated in patients with chronic mild to moderate BCRL.<\/jats:p>","DOI":"10.3390\/cancers15051545","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T01:36:09Z","timestamp":1677634569000},"page":"1545","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8117-7080","authenticated-orcid":false,"given":"Nele","family":"Devoogdt","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven\u2014University of Leuven, 3000 Leuven, Belgium"},{"name":"Department of Vascular Surgery, Centre for Lymphedema, UZ Leuven\u2014University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8491-6264","authenticated-orcid":false,"given":"Sarah","family":"Thomis","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Centre for Lymphedema, UZ Leuven\u2014University Hospitals Leuven, 3000 Leuven, Belgium"},{"name":"Department of Cardiovascular Sciences, KU Leuven\u2014University of Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"De Groef","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven\u2014University of Leuven, 3000 Leuven, Belgium"},{"name":"Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3826-5464","authenticated-orcid":false,"given":"An-Kathleen","family":"Heroes","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven\u2014University of Leuven, 3000 Leuven, Belgium"},{"name":"Department of Vascular Surgery, Centre for Lymphedema, UZ Leuven\u2014University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Nevelsteen","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Centre, UZ Leuven\u2014University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4927-0434","authenticated-orcid":false,"given":"Nick","family":"Gebruers","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, 2610 Antwerp, Belgium"},{"name":"Multidisciplinary Breast Clinic and Multidisciplinary Oedema Clinic, Antwerp University Hospital, 2650 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebren A. A.","family":"Tjalma","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Clinic and Multidisciplinary Oedema Clinic, Antwerp University Hospital, 2650 Antwerp, Belgium"},{"name":"Department of Medicine, University of Antwerp, MIPRO, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Belgrado","sequence":"additional","affiliation":[{"name":"Lymphology Research Unit, Universit\u00e9 libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2599-7313","authenticated-orcid":false,"given":"Chris","family":"Monten","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Ghent University Hospital, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4705-8735","authenticated-orcid":false,"given":"Marianne","family":"Hanssens","sequence":"additional","affiliation":[{"name":"Department of Oncology, Centre for Oncology, General Hospital Groeninge, 8500 Kortrijk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-6169","authenticated-orcid":false,"given":"Tessa","family":"De Vrieze","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven\u2014University of Leuven, 3000 Leuven, Belgium"},{"name":"Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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