Evidence map›Paper›PMID 42010368›Full record

ArticleJournal of surgical oncology2026

Superficial and Functional Imaging of the Posterior Upper Arm Pathway in the Healthy Population.

Madeleine Givant, Rosie Friedman, James E Fanning, Angela Chen, Sarah Thomson, Kathleen Shillue, Aaron Fleishman, José Luis Ciucci, Dhruv Singhal

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Madeleine GivantDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Rosie FriedmanDivision of Plastic Surgery, Department of Surgery, University of California Los Angeles, Los Angeles, California, USA.
James E FanningDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Angela ChenDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Sarah ThomsonDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Kathleen ShillueDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Aaron FleishmanDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
José Luis CiucciUniversity of Buenos Aires, Buenos Aires, Capital Federal, Argentina.
Dhruv SinghalDivision of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Funding

Organ Specific ProjectU54HL165440 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI HONG, YOUNG-KWON, SINGHAL, DHRUV · 2022 to 2025
$5.8M
Structural and Functional Remodeling of the Lymphatic System After Axillary Lymph Node DissectionR01HL157991 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Dhruv Singhal · 2021 to 2026
$3.1M
JOBST Lymphatic ResearchMadeleine Givant, James Fanning, Angela Chen, and Rosie FriedmanNational Heart, Lung, and Blood Institute of the National Institutes of Health R01HL157991NHLBI NIH HHS R01 HL157991NHLBI NIH HHS U54 HL165440NIH Common Fund U54HL165440
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe posterior upper arm (PUA), or tricipital, pathway is a superficial lymphatic channel that has been postulated to be a compensatory pathway for lymphatic drainage of the upper extremity following axillary lymph node dissection (ALND). The PUA pathway has been characterized in the breast cancer population but not in the healthy population.

methodsHealthy female volunteers were recruited for bilateral mapping of the upper extremities using indocyanine green (ICG) lymphography. Phenotypic variants of the PUA pathway were recorded.

results57 volunteers underwent ICG lymphography of the bilateral arms. The PUA pathway was visualized in 100% of arms. In 46% of arms, the pathway was continuous with the forearm (long bundle phenotype), whereas in 54% of arms, the pathway had no continuity with the forearm (short bundle phenotype).

conclusionThe PUA pathway was universally present in healthy volunteers. However, in comparison to our prior study, which was performed in patients with breast cancer prior to ALND, healthy volunteer arms more often displayed the short bundle phenotype. Defining the incidence of PUA pathway anatomic variants in healthy subjects is important to further understand its potential role in the development of lymphedema.

Indexed as

ArmLymphatic VesselsLymphographyAdultAgedAxillaBreast NeoplasmsFemaleHealthy VolunteersHumansIndocyanine GreenLymphedemaLymph Node ExcisionMiddle AgedIndocyanine GreenanatomyICG lymphographylymphaticslymphedemaPUA pathway

Identifiers

PMID42010368
PMCPMC13378777

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.