Table 2.

Staging and Classification for the Severity of Breast Cancer-related Lymphedema.

Staging	Method	Staging Features	Characteristics
International Society of Lymphology (ISL)	Physical findings	0: latent/sub-clinical I: spontaneously reversible II: spontaneously irreversible III: lymphostatic elephantiasis	Widely accepted
Campisi	Physical findings	I: initial/irregular edema, II: persistent LE III: persistent LE with lymphangitis IV: fibrolymphedema V: elephantiasis	Rely primarily on physical findings
Arm Dermal Backflow	ICG lymphography	0: No dermal backflow 1: Splash pattern around the axilla 2: Stardust limited between olecranon and axilla lymphangitis 3: Stardust distal to olecranon 4: Stardust involving the hand 5: Diffuse and stardust pattern involving the entire limb	Safe Information regarding the lymphatic flow for LVA planning
MD Anderson	ICG lymphography	0: No dermal backflow 1: Many patent lymphatics and minimal dermal backflow 2: Moderate number of patent lymphatics and segmental dermal backflow 3: Few patent lymphatics with extensive dermal backflow 4: Dermal backflow involving the hand 5: ICG does not move proximally to injection site	Safe Information regarding the lymphatic flow for LVA planning
Cheng’s Lymphedema grading	Circumferential difference and lymphoscintography	0: 0–9% 1: 10–19% 2: 20–29% 3: 30–39% 4: >40%	Objective method
Taiwan Lymphoscintigraphy Staging	Lymphoscintography	L-0: Normal Lymphatic Drainage P-1, P-2, P-3: Partial Obstruction T-4, T-5, T-6: Total Obstruction	Validated, Reliable

LE: Lymphedema; ICG: Indocyanine Green (ICG) Lymphography; LVA: Lymphovenous anastomosis.