Effectiveness of a Novel Low-level Laser Therapy Protocol in Managing Breast Cancer-Related Lymphedema

NCT07072780 | Completed

• 1 other identifier: D-2310-029-132
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

This study is a prospective, single-blinded, randomized controlled trial designed to evaluate the effectiveness of low-level laser therapy (LLLT) using two different wavelengths (904 nm and 650 nm) in patients with secondary lymphedema following breast cancer surgery. Participants will be randomly assigned to one of three groups: 904 nm LLLT, 650 nm LLLT, or sham treatment. The primary objective is to assess changes in arm volume and secondary lymphedema-related outcomes following a structured intervention program.

Conditions

Breast Cancer

Keywords

Low-level laser therapy; LLLT; Photobiomodulation; Randomized controlled trial

Outcome Measures

Primary Outcomes (2)

• Change in subcutaneous tissue thickness of the affected upper limb

  Subcutaneous tissue thickness will be measured using B-mode ultrasonography (7.5 MHz linear-array transducer, Siemens Medical Solutions). Measurements will be taken at five predefined anatomical sites of the affected upper limb: (1) midpoint of the wrist crease, (2) medial epicondyle, (3) lateral epicondyle, (4) 10 cm proximal and distal to the elbow joint along predefined lines on both medial and lateral sides, and (5) the web space between the first and second fingers. Thickness values will be used to assess local soft tissue changes in response to treatment.

  Baseline and after 10 sessions (approximately 3 weeks)

• Change in dermal backflow (DB) pattern on indocyanine green (ICG) lymphography

  Indocyanine green (Diagnogreen, 2.5 mg/mL) will be injected intradermally into the first and third web spaces of the affected hand (0.1 mL per site). To minimize discomfort, lidocaine HCl 2% with epinephrine (1:100,000) will be administered prior to injection. Lymphatic flow will be visualized using near-infrared fluorescence imaging. Dermal backflow patterns will be classified from Type I to Type V according to established staging criteria, reflecting the severity and distribution of lymphatic stasis. The DB stage will be used as an indicator of lymphatic dysfunction and treatment response.

  Baseline and after 10 sessions (approximately 3 weeks)

Secondary Outcomes (2)

• Change in extracellular fluid (ECF) ratio

  Baseline and after 10 sessions (approximately 3 weeks)

• Change in upper limb volume

  Baseline and after 10 sessions (approximately 3 weeks)

Study Arms (3)

904nm LLLT (LTU-904)

EXPERIMENTAL

Participants will receive low-level laser therapy using the LTU-904 device at a wavelength of 904 nm after complex decongestive physiotherapy (CDPT), which includes manual lymphatic drainage, remedial exercises, and intermittent pneumatic compression.

Device: Low-Level Laser Therapy (650 nm); Device: Sham Laser Therapy

650 nm LLLT (Salus Talent)

EXPERIMENTAL

Participants will receive low-level laser therapy using the Salus Talent device at a wavelength of 650 nm after complex decongestive physiotherapy (CDPT), which includes manual lymphatic drainage, remedial exercises, and intermittent pneumatic compression.

Device: Low-Level Laser Therapy (904 nm); Device: Sham Laser Therapy

Sham Laser Therapy

PLACEBO COMPARATOR

Participants will receive sham laser therapy with no active laser emission after complex decongestive physiotherapy (CDPT), which includes manual lymphatic drainage, remedial exercises, and intermittent pneumatic compression.

Device: Low-Level Laser Therapy (904 nm); Device: Low-Level Laser Therapy (650 nm)

Interventions

Low-Level Laser Therapy (904 nm) DEVICE

Low-level laser therapy using the LTU-904 device (RianCorp, Australia) at a wavelength of 904 nm, applied to the fibrotic area of the upper limb after CDPT.

650 nm LLLT (Salus Talent); Sham Laser Therapy

Low-Level Laser Therapy (650 nm) DEVICE

Low-level laser therapy using the Salus Talent device (Remed, USA) at a wavelength of 650 nm, applied to the fibrotic area of the upper limb after CDPT.

904nm LLLT (LTU-904); Sham Laser Therapy

Sham Laser Therapy DEVICE

Placebo laser therapy with no active laser emission, administered after CDPT.

650 nm LLLT (Salus Talent); 904nm LLLT (LTU-904)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Secondary lymphedema following breast cancer surgery

You may not qualify if:

• Primary lymphedema
• History of trauma, metastasis, or infection in both arms

Sponsors & Collaborators

• Pusan National University Hospital: lead

Study Sites (1)

Pusan National University Hospital

Busan, Seo-Gu, 49241, South Korea

Location

Related Publications (28)

• Ahmed Omar MT, Abd-El-Gayed Ebid A, El Morsy AM. Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res. 2011 Jan;165(1):82-90. doi: 10.1016/j.jss.2010.03.050. Epub 2010 Apr 18.

  PMID: 20538293 BACKGROUND

• Jang DH, Song DH, Chang EJ, Jeon JY. Anti-inflammatory and lymphangiogenetic effects of low-level laser therapy on lymphedema in an experimental mouse tail model. Lasers Med Sci. 2016 Feb;31(2):289-96. doi: 10.1007/s10103-015-1854-y. Epub 2015 Dec 29.

  PMID: 26714983 BACKGROUND

• Dirican A, Andacoglu O, Johnson R, McGuire K, Mager L, Soran A. The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema. Support Care Cancer. 2011 May;19(5):685-90. doi: 10.1007/s00520-010-0888-8. Epub 2010 May 6.

  PMID: 20445997 BACKGROUND

• Mayrovitz HN, Davey S. Changes in tissue water and indentation resistance of lymphedematous limbs accompanying low level laser therapy (LLLT) of fibrotic skin. Lymphology. 2011 Dec;44(4):168-77.

  PMID: 22458118 BACKGROUND

• Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C; National comprehensive cancer network. Cancer-Related Fatigue, Version 2.2015. J Natl Compr Canc Netw. 2015 Aug;13(8):1012-39. doi: 10.6004/jnccn.2015.0122.

  PMID: 26285247 BACKGROUND

• Buso G, Depairon M, Tomson D, Raffoul W, Vettor R, Mazzolai L. Lipedema: A Call to Action! Obesity (Silver Spring). 2019 Oct;27(10):1567-1576. doi: 10.1002/oby.22597.

  PMID: 31544340 BACKGROUND

• Gustavsson S, Kelly KA, Hench VS, Melton LJ 3rd. Giant gastric and duodenal ulcers: a population-based study with a comparison to nongiant ulcers. World J Surg. 1987 Jun;11(3):333-8. doi: 10.1007/BF01658111. No abstract available.

  PMID: 3604241 BACKGROUND

• Assis L, Moretti AI, Abrahao TB, de Souza HP, Hamblin MR, Parizotto NA. Low-level laser therapy (808 nm) contributes to muscle regeneration and prevents fibrosis in rat tibialis anterior muscle after cryolesion. Lasers Med Sci. 2013 May;28(3):947-55. doi: 10.1007/s10103-012-1183-3. Epub 2012 Aug 17.

  PMID: 22898787 BACKGROUND

• Smoot B, Chiavola-Larson L, Lee J, Manibusan H, Allen DD. Effect of low-level laser therapy on pain and swelling in women with breast cancer-related lymphedema: a systematic review and meta-analysis. J Cancer Surviv. 2015 Jun;9(2):287-304. doi: 10.1007/s11764-014-0411-1. Epub 2014 Nov 29.

  PMID: 25432632 BACKGROUND

• De Vrieze T, Vos L, Gebruers N, Tjalma WAA, Thomis S, Neven P, Nevelsteen I, De Groef A, Vandermeeren L, Belgrado JP, Devoogdt N. Protocol of a randomised controlled trial regarding the effectiveness of fluoroscopy-guided manual lymph drainage for the treatment of breast cancer-related lymphoedema (EFforT-BCRL trial). Eur J Obstet Gynecol Reprod Biol. 2018 Feb;221:177-188. doi: 10.1016/j.ejogrb.2017.12.023. Epub 2017 Dec 16.

  PMID: 29277358 BACKGROUND

• Kilmartin L, Denham T, Fu MR, Yu G, Kuo TT, Axelrod D, Guth AA. Complementary low-level laser therapy for breast cancer-related lymphedema: a pilot, double-blind, randomized, placebo-controlled study. Lasers Med Sci. 2020 Feb;35(1):95-105. doi: 10.1007/s10103-019-02798-1. Epub 2019 May 11.

  PMID: 31079232 BACKGROUND

• Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 2003 Jan;44(1):43-57.

  PMID: 12515876 BACKGROUND

• Unno N, Nishiyama M, Suzuki M, Tanaka H, Yamamoto N, Sagara D, Mano Y, Konno H. A novel method of measuring human lymphatic pumping using indocyanine green fluorescence lymphography. J Vasc Surg. 2010 Oct;52(4):946-52. doi: 10.1016/j.jvs.2010.04.067.

  PMID: 20619581 BACKGROUND

• Yamamoto T, Yamamoto N, Doi K, Oshima A, Yoshimatsu H, Todokoro T, Ogata F, Mihara M, Narushima M, Iida T, Koshima I. Indocyanine green-enhanced lymphography for upper extremity lymphedema: a novel severity staging system using dermal backflow patterns. Plast Reconstr Surg. 2011 Oct;128(4):941-947. doi: 10.1097/PRS.0b013e3182268cd9.

  PMID: 21681123 BACKGROUND

• Narushima M, Yamamoto T, Ogata F, Yoshimatsu H, Mihara M, Koshima I. Indocyanine Green Lymphography Findings in Limb Lymphedema. J Reconstr Microsurg. 2016 Jan;32(1):72-9. doi: 10.1055/s-0035-1564608. Epub 2015 Sep 30.

  PMID: 26422172 BACKGROUND

• Yoon JA, Shin MJ, Shin YB, Kim K, Park H, Kang T, Kong IJ, Kim H, Park MS, Kim JH. Correlation of ICG lymphography and lymphoscintigraphy severity stage in secondary upper limb lymphedema. J Plast Reconstr Aesthet Surg. 2020 Nov;73(11):1982-1988. doi: 10.1016/j.bjps.2020.08.055. Epub 2020 Aug 25.

  PMID: 32952056 BACKGROUND

• Niimi K, Hirai M, Iwata H, Miyazaki K. Ultrasonographic findings and the clinical results of treatment for lymphedema. Ann Vasc Dis. 2014;7(4):369-75. doi: 10.3400/avd.oa.14-00104. Epub 2014 Dec 25.

  PMID: 25593621 BACKGROUND

• Lim CY, Seo HG, Kim K, Chung SG, Seo KS. Measurement of lymphedema using ultrasonography with the compression method. Lymphology. 2011 Jun;44(2):72-81.

  PMID: 21949976 BACKGROUND

• Polat AV, Ozturk M, Polat AK, Karabacak U, Bekci T, Murat N. Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer-Related Lymphedema. J Ultrasound Med. 2020 Apr;39(4):795-803. doi: 10.1002/jum.15162. Epub 2019 Nov 9.

  PMID: 31705687 BACKGROUND

• Cornish BH, Thomas BJ, Ward LC. Improved prediction of extracellular and total body water using impedance loci generated by multiple frequency bioelectrical impedance analysis. Phys Med Biol. 1993 Mar;38(3):337-46. doi: 10.1088/0031-9155/38/3/001.

  PMID: 8451277 BACKGROUND

• Bae SH, Kim WJ, Seo YJ, Kim J, Jeon JY. Bioimpedance Analysis for Predicting Outcomes of Complex Decongestive Therapy for Gynecological Cancer Related Lymphedema: A Feasibility Study. Ann Rehabil Med. 2020 Jun;44(3):238-245. doi: 10.5535/arm.19102. Epub 2020 Jun 30.

  PMID: 32640783 BACKGROUND

• Mayrovitz HN. Assessing local tissue edema in postmastectomy lymphedema. Lymphology. 2007 Jun;40(2):87-94.

  PMID: 17853619 BACKGROUND

• Barbosa RI, Guirro ECO, Bachmann L, Brandino HE, Guirro RRJ. Analysis of low-level laser transmission at wavelengths 660, 830 and 904 nm in biological tissue samples. J Photochem Photobiol B. 2020 Aug;209:111914. doi: 10.1016/j.jphotobiol.2020.111914. Epub 2020 May 22.

  PMID: 32516626 BACKGROUND

• Carati CJ, Anderson SN, Gannon BJ, Piller NB. Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer. 2003 Sep 15;98(6):1114-22. doi: 10.1002/cncr.11641.

  PMID: 12973834 BACKGROUND

• Wang Y, Ge Y, Xing W, Liu J, Wu J, Lin H, Lu Y. The effectiveness and safety of low-level laser therapy on breast cancer-related lymphedema: An overview and update of systematic reviews. Lasers Med Sci. 2022 Apr;37(3):1389-1413. doi: 10.1007/s10103-021-03446-3. Epub 2021 Nov 15.

  PMID: 34779937 BACKGROUND

• E Lima MT, E Lima JG, de Andrade MF, Bergmann A. Low-level laser therapy in secondary lymphedema after breast cancer: systematic review. Lasers Med Sci. 2014 May;29(3):1289-95. doi: 10.1007/s10103-012-1240-y. Epub 2012 Nov 29.

  PMID: 23192573 BACKGROUND

• Baxter GD, Liu L, Petrich S, Gisselman AS, Chapple C, Anders JJ, Tumilty S. Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. BMC Cancer. 2017 Dec 7;17(1):833. doi: 10.1186/s12885-017-3852-x.

  PMID: 29216916 BACKGROUND

• Lahtinen T, Seppala J, Viren T, Johansson K. Experimental and Analytical Comparisons of Tissue Dielectric Constant (TDC) and Bioimpedance Spectroscopy (BIS) in Assessment of Early Arm Lymphedema in Breast Cancer Patients after Axillary Surgery and Radiotherapy. Lymphat Res Biol. 2015 Sep;13(3):176-85. doi: 10.1089/lrb.2015.0019. Epub 2015 Aug 25.

  PMID: 26305554 BACKGROUND

MeSH Terms

Conditions

Breast Neoplasms

Interventions

Low-Level Light Therapy

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Laser Therapy; Therapeutics; Phototherapy

Study Officials

• Jin A Yoon, MD, Ph.D

  Pusan National University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Department of Rehabilitation Medicine

Study Record Dates

• First Submitted: June 20, 2025
• First Posted: July 18, 2025
• Study Start: November 23, 2023
• Primary Completion: December 26, 2024
• Study Completion: December 31, 2024
• Last Updated: July 18, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

KR (1)