Safety Study of Bevacizumab to Treat Women With a History of Breast Cancer and Suffering From Upper Extremity Lymphedema

Inclusion Criteria:

* Women with a history of breast cancer status post (s/p) prior surgical resection (i.e., either lumpectomy and radiation, modified radical mastectomy or radical mastectomy) with lymphedema defined as a difference in limb volume of at least 500 ml by perometric assessment
* Lymphedema may be newly diagnosed or previously treated as long as it is Stage I (pitting) or II (fibrosis) at the time of study entry.
* No known evidence of recurrent or active metastatic breast cancer
* No prior chemotherapy within 6 months of study entry and has recovered to grade 1 or less from the toxicity of all prior chemotherapy or radiation therapy (with the exception of alopecia); ongoing anti-estrogen therapy for post-menopausal survivors is permissible.
* Normal end organ function defined as: serum creatinine \< 1.5 mg/dl or a calculated creatinine clearance \> 50 ml/min; SGOT and SGPT \< 2.5 X upper limit of normal (ULN); total bilirubin \< 1.5 X ULN; absolute neutrophil count (ANC) \> 1,500 cells/µl; hemoglobin \> 10 g/dl (without transfusions); platelet count \> 100,000/µl; serum albumin within normal limits (WNL).

Exclusion Criteria:

* Stage III (lymphostatic elephantiasis) lymphedema
* Clinical evidence of bilateral lymphedema. Those patients who have undergone bilateral breast cancer surgery or prophylactic mastectomy on the non-cancerous breast will be excluded.
* Any prior history of deep venous thrombosis (DVT) or pulmonary embolus (with the exception of prior line-related thrombotic events) or myocardial infarction (MI), cerebrovascular accident (CVA) or any other arterial thromboembolic event (i.e., transient ischemic attack \[TIA\], reversible ischemic neurologic deficit \[RIND\], history of angina pectoris, clinically significant peripheral vascular disease with claudication, etc.)
* Patients with problems with wound healing (e.g., diabetic ulcers), gastrointestinal fistula
* Patients receiving therapeutic anti-coagulation including full dose aspirin or non-steroidal anti-inflammatory agents known to inhibit platelet function (low dose coumadin for port prophylaxis and low dose aspirin are allowed)
* Untreated hypertension with a baseline systolic blood pressure (SBP) of \> 150 mmHg or a diastolic blood pressure (DBP) \>100 mmHg will be excluded (stable treated hypertension with values less than those noted will be eligible).
* A history of infectious complications of the involved arm or those with any contraindication to MLD + CB \[e.g., congestive heart failure (CHF), DVT, acute or chronic renal failure\] will be excluded.
* Women with a history of CHF \[New York Heart Association (NYHA) Class II or greater\] will be excluded.
* Pregnant or breast-feeding
* Unwilling to use an appropriate form of barrier contraception for the duration of the study and for three months following the last dose of bevacizumab
* Those patients who are actively undergoing MLD and/or CB at the time of study entry and for up to 4 weeks prior to entry
* Unable to provide written informed consent or to comply with study procedures
* Baseline urine protein : creatinine ratio \> 1.0
* Known evidence of a bleeding diathesis or coagulopathy