Reduction Of Lymphedema Research Articles

Elephantiasis and its cure: case report

Introduction: Lymphedema is a clinical condition stemming from a lymphatic system failure. The insufficiency of the lymphatic system can causes the abnormal accumulation of protein-rich fluid in the interstitial, which triggers a adverse consequence such a and fibrosis. This study describes a case of a patient who has been cured of elephantiasis for ten years but continues to have lymphedema. Description case: Patient information: A 78-year-old woman had a history of bilateral lower limb lymphedema, clinical diagnosis that had been worsening throughout her life bilateral despite undergoing treatment and had progressed to stage III (elephantiasis). Clinical findings: The patient was sent to the Clínica Godoy-Sao Jose do Rio Preto-Brazil ten years ago and reported having undergone several forms of treatment, but without impeding the progression of the condition. Therapeutic intervention: The patient was submitted to intensive treatment for three weeks, during which time a 21-kilogram reduction in weight and a 66-cm reduction in circumference occurred. After three weeks, the patient began undergoing treatment at home with laced compression stockings. At the follow-up evaluation, electrical bioimpedance analysis, perimeter measurements and volumetry were performed, which revealed the reduction in lymphedema to standards of normality. The patient has completed 10 years of treatment and has maintained the results using compression stockings. Conclusion: Elephantiasis is curable, but lymphedema is not. Like any other chronic disease, constant treatment is needed to maintain the results.

Primary Lymphovenous Anastomosis After Extended Soft Tissue Resection in the Medial Thigh for Reduction of Lymphocele and Lymphedema.

Postoperative chronic lymphocele and lymphedema represent severe burdens for soft tissue sarcoma patients who are already physically handicapped after an extensive surgery and a long recovery time. Incidences are high in the upper medial thigh. We have shifted our focus to lymphedema and lymphocele risk reduction with immediate lymphovenous anastomosis (LVA) after sarcoma resection. We performed immediate lymphatic reconstruction in 11 patients after soft tissue sarcoma resection in the upper medial thigh. The postoperative course was followed up closely, and postoperative occurrence of lymphocele and lymphedema was clinically assessed. A literature search outlining the latest clinical data, current treatment strategy landscape, and their application into clinical practice was added to the investigation. A total of 19 LVA and 2 lympho-lymphatic anastomoses were performed in 11 patients immediately after tumor resection in an end-to-end manner. We found a postoperative lymphedema rate of 36% and a postoperative lymphocele rate of 27%. Mean follow-up time was 17 months. Average tumor volume was 749 cc. Our literature search yielded 27 articles reporting on immediate LVA in cancer patients. Incidences of secondary lymphedema after LVA for lymphedema prevention vary between 0% and 31.1%. Lymphocele prevention with LVA is poorly studied in sarcoma patients. Immediate lymphatic reconstruction improved the overall postoperative course of our patients. The current literature does not serve with high-quality studies about primary LVA preventing lymphedema and lymphocele formation. We conclude that this technique should be seen as an additional concept to achieve overall better postoperative outcomes in these challenging surgical settings. We strongly recommend to either anastomose or ligate severed lymphatics under the microscope primarily after sarcoma resection in the upper medial thigh area.

History of surgical treatment of lymphatic drainage at the Department of Plastic and Aesthetic Surgery, St. Anne's University Hospital in Brno.

The Department of Plastic and Aesthetic Surgery, St. Anne's University Hospital in Brno, and Faculty of Medicine of Masaryk University, Brno, has a long history of surgical treatment of lymphedema and elephantiasis, which started in 1970s. There were many types of surgeries described and performed at our department - starting with prof. Bařinka's radical operation of elephantiasis, then lower limb end-to-side lymphovenous anastomosis pulled through the wall to the great saphenous vein, and genital lymphedema reduction. We call this era "the first period" of surgical lymphedema treatment. "The second period" started in 2016 by using free flaps with lymph nodes or vascularized lymph nodes and using microsurgical techniques of end-to-end, end-to-side and side-to-end lymphovenous anastomoses to the subcutaneous veins of a small calibre, which then drain the lymph into the blood stream. "The third period" started 2 years ago after the visit of prof. Yang from Taiwan - we started to use the method of single stitch end-to-side anastomosis to big subcutaneous veins like the great saphenous vein or the cephalic vein.

Effects of Ultrasound-guided Lower Abdominal Lymphaticovenous Anastomosis on Lower Abdominal Lymphedema

Summary: Lymphedema of the lower extremities can be further complicated by lymphedema of the lower abdomen and genitalia. This study aimed to clarify the effect of lower abdominal lymphaticovenous anastomosis (LVA) on lower abdominal lymphedema. The patient was a 61-year-old woman. At the age of 49 years, she underwent treatment for ovarian cancer, including pelvic lymphadenectomy, and she developed lymphedema in the lower abdomen and bilateral thigh 2 years later. During lymphoscintigraphy, isotopes injected into the dorsum of the bilateral feet accumulated in the corresponding areas, indicating that lymph flowed into these areas from the legs. Compression therapy was performed with a girdle; however, its effect was limited. According to the lymphoscintigraphic findings, we performed LVA in the bilateral thighs (two anastomoses each), and the edema symptoms slightly improved postoperatively. However, as edema was still present and the patient sought further relief, we evaluated the lymphatic vessels in the lower abdomen using lymphatic ultrasound and found dilated lymphatic vessels. We performed another LVA in the lower abdomen 1 year after the first LVA (two anastomoses in the right abdomen, one anastomosis in the left abdomen, and an additional anastomosis in the bilateral thighs). The patient’s subjective symptoms improved, and ultrasonography showed a reduction in abdominal lymphedema at 7 months follow-up. For lymphedema in the lower abdomen and genital area that does not improve with compression therapy, appropriate examination to evaluate lymphatic flow and lymphatic degeneration is necessary, and LVA in the lower abdomen may be effective.

Complete Reduction of Leg Lymphedema after Liposuction: A 5-Year Prospective Study in 67 Patients without Recurrence

Background: Lymphedema leads to adipose tissue deposition that cannot be removed using conservative methods. Previous studies have shown a complete reduction in excess volume in limbs with lymphedema when treated with liposuction and controlled compression therapy (CCT). We present the long-term outcomes of all patients treated with liposuction and CCT for lower extremity lymphedema (LEL) who were followed up for 5 years. Methods: Sixty-seven LEL patients underwent liposuction and CCT. Thirty-six patients had primary lymphedema and 31 patients had secondary lymphedema. The outcomes included excess leg volume over a follow-up period of 5 years. Any association between patient characteristics and treatment outcomes was analyzed. Results: The preoperative excess volume prior was 3515 mL [interquartile range (IQR): 2225–5455 mL], and the volume ratio to the unaffected leg was 1.35 (IQR: 1.25–1.53). One year after treatment, the excess volume decreased by 101% (IQR: 84–116). The decrease in excess volume continued during the 5-year follow-up, and at the end of the study, the excess volume had decreased by 115% (IQR: 98–124). No major complications were noted. Conclusions: Liposuction and CCT are safe and effective procedures for removing excess adipose tissue and normalizing the leg volume in patients with late-stage LEL. When no satisfactory results are obtained with conservative methods, such as complex decongestive therapy, and there is no or minimal pitting on limb examination, excess adipose tissue is present, and liposuction can be considered.

The Effect of Education on Knowledge Regarding Breast Cancer Related Lymphedema Risk Reduction and Prevention Among Nursing Personnel.

Aim The development of lymphedema post-breast-cancer surgery has been identified as a significant burden worldwide, with nurses at the forefront of prevention and risk reduction practices.Prevention is of crucial importance to avoid lymphedema formation and its complications.Thisstudy aims to assess the knowledge gained through an educational session regarding risk reduction and prevention of breast cancer-related lymphedema (BCRL) among nursing professionals and compare the pre-test and post-test knowledge. Methods and material The research approach was quantitative in nature, and the design adopted was a pre-experimental, one-group pre-test post-test design.The study was conducted in a 400-bed multispecialty teaching hospital in Bangalore, Karnataka. After obtaining formal permission from the authorities, the participants were approached and informed about the purpose of the study.Eighty-four staff nurses working with breast cancer-related lymphedema (BCRL) patients participated in the study. The data for the study was collected using a validated questionnaire based on the National Lymphedema Network's (NLN) breast cancer-related lymphedema (BCRL) risk reduction and preventive guidelines.The questionnaire consisted of two sections.Section A consisted of the staff nurses' demographic data, and Section B consisted of questions on risk reduction and prevention of lymphedema. The pre-test was conducted, followed by a structured teaching session on risk reduction and prevention of lymphedema among 84 staff nurses working with BCRL patients.After the teaching session, the post-test was conducted. Results Descriptive and inferential statistics were used for analysis in this study.The t-test determined the statistical significance using the software SPSS (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). The result showed that the mean knowledge score was 4.286 with SD 0.97 in the pre-test, which increased to 4.452 with SD 1.511 with a significant p-value (<0.001). Conclusion According to the study's findings, nurses must get standardized lymphedema training in order to prevent lymphedema from developing in patients having breast cancer surgery.The study's outcome has implications on the focus areas for nurses in the context of the team's adoption and dissemination of breast cancer-related lymphedema preventive measures. Key messages of this study are - 1) BCRL is an irreversible, progressive complication with no cure if not diagnosed early. 2) Poor knowledge of lymphedema prevention among nurses leads to frustration for BCRL patients. 3) Risk reduction and prevention education enable the patient to reduce BCRL complications, minimize the severity of the condition, and improve the quality of life. 4) Pre-habilitation - patient education on early diagnosis and risk reduction/prevention of BCRL reduces the cost, time, and energy for the patient and health care delivery system.

D138. A 28-year Single Institutional Experience of Complete Reduction of Extremity Lymphedema Using Suction Assisted Lipectomy

D138. A 28-year Single Institutional Experience of Complete Reduction of Extremity Lymphedema Using Suction Assisted Lipectomy

PC11. Proposed Protocol for Optimization of High Risk Lymphedema Resections

PURPOSE: Late-stage lymphedema is a debilitating disease that is often impervious to conservative treatments, far beyond microsurgical options but not so advanced as to require the Charles procedure, and becomes a unique surgical challenge without a current, well-defined protocol for approaching resection. Our study reviews modifications made to a technique developed over a decade and aims to define a protocol that optimizes outcomes for these high risk lymphedematous mass excisions. METHODS: Single institution retrospective review of 21 lower extremity resections in 7 patients performed over 10 years by two surgeons. RESULTS: Substantial reduction of lymphedema was achieved in all 21 cases involving 7 patients with only 1 recurrence requiring an additional resection 6 years later. Average incision length was 28cm. All but one patients had BMI >35. The complication rate was 33% and included 2 seromas and 6 wound dehiscence requiring re-operation. Use of drains and negative pressure wound therapy was consistent, but did not preclude complications. Use of Ligasure device reduced operative time by 1/3. Two cases admitted for pre-operative bedrest had no complications. CONCLUSION: Overall there is not significant literature published about lymphedema resections and this relatively rare type of surgery remains high risk for complications. Crucial measures have been identified to improve outcomes such as a staged approach, pre-admitting for offloading and fluid management, use of Ligasure for expedient lymphostasis, drains, postoperative bedrest with negative pressure therapy, and continue compression as outpatient. Our group presents this case series and a protocol for optimization.

Efficacy of post mastectomy exercises on reduction of lymphedema among patients undergone mastectomy: A pre-experimental study from central rural India

Efficacy of post mastectomy exercises on reduction of lymphedema among patients undergone mastectomy: A pre-experimental study from central rural India

Complete Reduction of Leg Lymphedema in 126 Patients with Liposuction without Recurrence - 20 Years’ Follow-up

Complete Reduction of Leg Lymphedema in 126 Patients with Liposuction without Recurrence - 20 Years’ Follow-up

Influence of Exercises on Lymphedema Reduction following Breast Cancer Surgery

Influence of Exercises on Lymphedema Reduction following Breast Cancer Surgery

Клинический пример лечения пациента с посттравматическим комбинированным обширным дефектом тканей голени

Introduction Treatment of patients with open fractures of long bones with soft tissue defects remains one of the most difficult tasks of current traumatology. Material and methods We repor a clinical case of the treatment of a patient with an extensive purulent wound, a defect in the tibia, chronic damage to the anterior neurovascular bundle, tendons and muscles of the anterior and lateral groups of the lower leg, post-traumatic severe lymphedema of the right foot. The complex of the treatment process included debride-ment of the wound, orthoplastic surgery using Ilizarov transosseous osteosynthesis and elements of plastic surgery. The defect of the right tibia was managed using a non-free vascularized peroneal compound flap from the opposite tibia. Results The treatment of this patient resulted in the arrest of osteomyelitis, a significant reduction in foot lymphedema, restoration of weight-bearing and functional capacity of the right lower limb. This was achieved by replacing a significant defect in the tibia and soft tissues under conditions of long-term wound and scar processes and compromised main blood flow in the affected lower leg. Discussion The main operations for management of complex defects in the tissues of the lower leg are demonstrated. Among them, the main ones are transosseous osteosynthesis according to Ilizarov and microsurgical replacement with a vascularized complex of tissues.

Which physical therapy intervention is most effective in reducing secondary lymphoedema associated with breast cancer? Protocol for a systematic review and network meta-analysis

IntroductionLymphoedema associated with breast cancer is caused by an interruption of the lymphatic system, together with factors such as total mastectomy, axillary dissection, positive lymph nodes, radiotherapy, use of taxanes...

Phase 1 Lymfactin® Study: 24-month Efficacy and Safety Results of Combined Adenoviral VEGF-C and Lymph Node Transfer Treatment for Upper Extremity Lymphedema

Lymphedema is a common problem after breast cancer treatment. Lymfactin® is a prolymphangiogenic growth factor vector inducing the expression of human vascular endothelial growth factor C (VEGF-C). It promotes growth and repair of lymphatic vessels. Lymfactin® was combined with microvascular lymph node transfer surgery (VLNT) to study the safety and efficacy of the treatment in breast cancer-related upper limb lymphedema (BCRL) patients. This is a continuation study with a 3 year efficacy and 5 year safety follow-up. Fifteen patients were recruited in the study between June 2016 and February 2018. Three patients received a lower dose (1×1010 viral particles (vp)), and 12 patients received a higher dose (1×1011 vp) of Lymfactin®, respectively. In the higher dose group, the reduction of excess arm volume was on average 46% after the 12 month follow-up, and the transport index was improved in 7/12 patients. At baseline, removal of the compression garment for 7 days resulted in significant arm swelling (105.7±161.0 ml, p=0.0253). However, at 12 months, there was less and not significant swelling after removal of the garment (84.4±143.0 ml, p=0.0682). Lymphedema Quality of Life Inventory (LQOLI or LyQLI) questionnaire showed significant and sustained improvement of quality of life. During 24 months' of follow-up, the results indicate that Lymfactin® is well tolerated. The most promising findings were a 46% reduction in excess arm volume and a nonsignificant volume increase after garment removal at 12 months, suggesting that there is potential for the reduction of lymphedema.

Effect of Lymphaticovenous Anastomosis on Muscle Edema, Limb, and Subfascial Volume in Lower Limb Lymphedema: MRI Studies.

BACKGROUND:Although satisfactory volume reduction in secondary unilateral lower limb lymphedema after lymphaticovenous anastomosis (LVA) in the affected limb has been well reported, alleviation of muscle edema and the impact of LVA on the contralateral limb have not been investigated.STUDY DESIGN:This retrospective cohort study enrolled patients who underwent supermicrosurgical LVA between November 2015 and January 2017. Pre- and post-LVA muscle edema were assessed using fractional anisotropy (FA) and apparent diffusion coefficient (ADC). The primary endpoint was changes in limb/subfascial volume assessed with magnetic resonance volumetry at least 6 months after LVA.RESULTS:Twenty-one patients were enrolled in this study. Significant percentage reductions in post-LVA muscle edema were found in the affected thigh (83.6% [interquartile range = range of Q1 to Q3; 29.8–137.1] [FA], 53.3% [27.0–78.4] [ADC]) as well as limb (21.7% [4.4–26.5]) and subfascial (18.7% [10.7–39.1]) volumes. Similar findings were noted in the affected lower leg: 71.8% [44.0–100.1] (FA), 59.1% [45.8–91.2] (ADC), 21.2% [6.8–38.2], and 28.2% [8.5–44.8], respectively (all p < 0.001). Significant alleviation of muscle edema was also evident in the contralateral limbs (thigh: 25.1% [20.4–57.5] [FA]; 10.7% [6.6–17.7] [ADC]; lower leg: 47.1% [35.0–62.8] [FA]; 14.6% [6.5–22.1] [ADC]; both p < 0.001), despite no statistically significant difference in limb and subfascial volumes.CONCLUSIONS:Our study found significant reductions in muscle edema and limb/subfascial volumes in the affected limb after LVA. Our findings regarding edema in the contralateral limb were consistent with possible lymphedema-associated systemic influence on the unaffected limb, which could be surgically relieved.

A Study Protocol on the Effectiveness of Post Mastectomy Exercises in Breast Cancer Patients on Reduction of Lymphedema and Improving Range of Motion among Patients Undergone Mastectomy

Background: Breast cancer is the most commonly diagnosed type of cancer in the world and it is a major stressor in women's lives. Breast cancer cases are increasing in both rural and urban settings. Mastectomy is a procedure that removes the breast to prevent cancer cells from returning. Many complications can develop after a mastectomy but lymphedema and limited range of motion are the most prevalent. The present study aimed to assess the effectiveness of post mastectomy exercises in breast cancer patients on reduction of lymphedema and improving range of motion among patients undergone mastectomy.&#x0D; Objectives:&#x0D; &#x0D; To assess pre interventional level of lymphedema among patients undergone mastectomy.&#x0D; To assess pre interventional range of motion among patients undergone mastectomy.&#x0D; To evaluate the effectiveness of post mastectomy exercises in reducing lymphedema among patients undergone mastectomy&#x0D; To evaluate the effectiveness of post mastectomy exercises in improving range of motion among patients undergone mastectomy.&#x0D; To associate demographic variable with post mastectomy exercises.&#x0D; To associate correlation of post mastectomy exercise with lymphedema and range of motion.&#x0D; &#x0D; Methodology: A pre interventional one group pretest posttest design would be adopted to assess the effectiveness of post mastectomy exercises in breast cancer patients on reduction of lymphedema and improving range of motion among patients undergone mastectomy. In this study interventional analytical study will be used. Purposive sampling technique will be used to collect the data. The study will include 30 patients undergone mastectomy will be assessed by using American lymphology lymphedema scale and Elvaru STJ (Subtalar joint) range of motion and range of motion reliability tool with the help of inch tape and goniometer and then post mastectomy exercises will be teach by researcher as intervention.&#x0D; Expected Results: The goal of this study is to see how effective post-mastectomy exercises are at reducing lymphedema and improving range of motion in breast cancer patients who had undergone mastectomy. Teaching post-mastectomy exercises can help the respondents reduce lymphedema and improve their range of motion.

Effects of Intermittent Pneumatic Compression on Lower Limb Lymphedema in Patients with Type 2 Diabetes Mellitus: A Pilot Randomized Controlled Trial

Background and Objectives: Diabetes mellitus type 2 (T2DM) is a chronic disease associated with fluid accumulation in the interstitial tissue. Manual lymphatic drainage (MLD) plays a role in reducing lymphoedema, like intermittent pneumatic compression (IPC). By the present pilot study, we aimed to evaluate the efficacy of a synergistic treatment with MLD and IPC in reducing lower limb lymphedema in T2DM patients. Materials and Methods: Adults with a clinical diagnosis of T2DM and lower limb lymphedema (stage II–IV) were recruited from July to December 2020. Study participants were randomized into two groups: experimental group, undergoing a 1-month rehabilitative program consisting of MLD and IPC (with a compression of 60 to 80 mmHg); control group, undergoing MLD and a sham IPC (with compression of <30 mmHg). The primary outcome was the lower limb lymphedema reduction, assessed by the circumferential method (CM). Secondary outcomes were: passive range of motion (pROM) of hip, knee, and ankle; quality of life; laboratory exams as fasting plasma glucose and HbA1c. At baseline (T0) and at the end of the 1-month rehabilitative treatment (T1), all the outcome measures were assessed, except for the Hb1Ac evaluated after three months. Results: Out of 66 T2DM patients recruited, only 30 respected the eligibility criteria and were randomly allocated into 2 groups: experimental group (n = 15; mean age: 54.2 ± 4.9 years) and control group (n = 15; mean age: 54.0 ± 5.5 years). At the intra-group analysis, the experimental group showed a statistically significant improvement of all outcome measures (p < 0.05). The between-group analysis showed a statistically significant improvement in pROM of the hip, knee, ankle, EQ-VAS, and EQ5D3L index at T1. Conclusions: A multimodal approach consisting of IPC and MLD showed to play a role in reducing lower limb lymphedema, with an increase of pROM and HRQoL. Since these are preliminary data, further studies are needed.

Treatment Outcomes of Manual Lymphatic Drainage in Pediatric Lymphedema

Pediatric lymphedema can result in irreversible, debilitating limb swelling, tissue fibrosis, skin ulcers, infection, and impaired limb function in children at an early age. Manual lymphatic drainage (MLD) is a noninvasive technique, which is a part of intensive decongestive therapy to reroute lymphatic flow to healthy channels used to manage lymphedema. Outcomes of this treatment option in children have not been studied. We evaluated the effect of decongestive therapy involving MLD in pediatric patients with complex lymphatic anomalies by measuring treatment progress and functional outcomes via changes in limb circumference, limb functionality, dexterity, skin quality, and pain. A single-institution retrospective study on a cohort of 8 pediatric patients with lymphatic anomalies who completed a course of MLD was conducted from 2015 to 2017 to investigate the role MLD plays in their lymphedema reduction. Pain scores were measured on a scale of 0-10, with 0 being no pain and 10 being the worst pain imaginable. The functional performance was measured by the Canadian Occupational Performance Measurement questionnaire. Among all patients, there were 4 cases affecting the upper extremities, 4 affecting the lower extremities, and 3 affecting the truncal region. Five of 8 patients demonstrated a reduction in lymphedema with an average girth reduction of 8.2% in the lower extremities, 3.0% in the upper extremities, and 7.4% in the truncal regions. In unilateral cases, the difference in limb circumference between the affected and normal extremity decreased by an average of 25.6%. Four patients completed the Canadian Occupational Performance Measurement questionnaire with an average improvement of 30% in daily task performance. Three patients reported complete resolution of pain. MLD can be used as a reliable noninvasive method for decongestion and analgesia to delay the onset of lymphedema-associated fibrosis and long-term disability in children with complex lymphatic malformations.

Extracorporeal shock wave therapy as a potential therapeutic tool for breast cancer related lymphedema: a narrative review of in vitro, animal and clinical studies

Background: The treatment of breast cancer related lymphedema (BCRL) focuses on the alleviation symptoms. One of the innovative, non-invasive therapies used for this condition is extracorporeal shock wave therapy (ESWT). Aim of the study: To review the available literature and evaluate the effectiveness of ESWT in the treatment of secondary lymphedema (in vitro works, animal experiments) and lymphedema associated with the treatment of breast cancer. Material and methods: The scientific literature review was conducted from October to December 2020. The review was carried out by searching scientifically recognized medical databases, including PubMed, MEDLINE and PEDro. Date restrictions were not applied. As there are only a few clinical studies assessing the effectiveness of ESWT on the reduction of lymphedema, case reports, animal experiments and in vitro works were included in the review. Articles written in a language other than English were excluded. Results: In total, the analysis included twelve studies, including seven clinical trials, one case report, three animal experiments and one in vitro test. Conclusions: Based on the results of the analyzed articles, ESWT can be an effective therapeutic tool for lymphedema occurring after breast cancer treatment. Unfortunately, the level of evidence is relatively weak since the number of publications on this subject is still quite low. The accumulated results indicate the need for further clinical trials.

Cost-effectiveness of photobiomodulation therapy for the prevention and management of cancer treatment toxicities: a systematic review.

To identify and summarize the evidence on the cost-effectiveness of photobiomodulation (PBM) therapy for the prevention and treatment of cancer treatment-related toxicities. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 1490 studies were identified, and after a two-step review, 4 articles met the inclusion criteria. The included studies analyzed the cost-effectiveness of PBM therapy used in the context of lymphedema for breast cancer and oral mucositis (OM) induced by chemotherapy and radiotherapy. Better outcomes were associated with PBM therapy. The incremental cost-effectiveness ratio ranged from 3050.75 USD to 5592.10 USD per grade 3-4 OM case prevented. PBM therapy cost 21.47 USD per percentage point reduction in lymphedema in comparison with 80.51 USD for manual lymph drainage and physical therapy. There is limited evidence that PBM therapy is cost-effective in the prevention and treatment of specific cancer treatment-related toxicities, namely, OM and breast cancer-related lymphedema. Studies may have underreported the benefits due to a lack of a comprehensive cost evaluation. This suggests a wider acceptance of PBM therapy at cancer treatment centers, which has thus far been limited by the number of robust clinical studies that demonstrate cost-effectiveness for the prevention and treatment of toxicities.