Breast cancer related lymphedema-novel regenerative therapies: a narrative review

Abstract

<p><strong>Background and Objective: </strong>In the last decade, surgical treatment options for breast cancer-related lymphedema (BCRL), such as microvascular autologous lymph node transfer (ALNT) and/or lymphatic venous anastomosis (LVA) have become popular. The results have been promising, but the benefit has been seen mostly on patients suffering from early stages of lymphedema. BCRL can deteriorate patient well-being in a significant manner. Our objective is to review the current field of novel regenerative therapies in association with surgical reconstruction of the lymphatic vasculature and further provide ideas for possible future improvements in the treatment of lymphedema.</p><p><strong>Methods: </strong>We searched the PubMed Medline database for regenerative therapies for BRCL during the years 2000–2022. Articles written in English were included.</p><p><strong>Key Content and Findings: </strong>Results from ALNT and/or LVA seem to improve with growth factor therapy and nanofibrillar collagen scaffold insertion, also adipose-derived stem cells (ADSCs) have improved results in some studies. These methods do not target the fibrofatty tissue in lymphedema, and liposuction (LIPO) can be added to the treatment.</p><p><strong>Conclusions: </strong>Regenerative therapies have shown promising results in the treatment of lymphedema in experimental models. The research has proceeded to clinical studies in several treatment options but to date no curative treatment has been found. The translation of result of experimental studies to the clinical practice has not been straightforward. The pathogenesis of BCRL is multifactorial and patients are very heterogenous, which creates challenges to the researchers in this field.</p>