The use of bioimpedance spectroscopy (BIS) appeared to more effectively support early detection of lymphedema associated with breast cancer than was seen with reliance on circumferential limb volume measurements. The results of this study were published in the European Journal of Breast Health.
Breast cancer-related lymphedema (BCRL) is a common condition in patients treated for breast cancer. BCRL involves an accumulation of fluid in interstitial spaces, resulting from changes to the lymphatic system following surgery and/or radiation therapy for breast cancer, explained the study investigators. They also noted screening patients for BCRL development is a challenge. This study was undertaken with the aim of comparing BIS and circumferential volume measurements based on rates of subclinical/clinical BCRL identified with each method.
The study, which was based in Ankara, Turkey, involved a 6-month surveillance program for female patients with breast cancer treated through surgery. Evaluated patients underwent unilateral surgery that involved either breast conservation or mastectomy and included axillary lymph node dissection. Lymphedema was evaluated through limb volume measurements using BIS and circumferential approaches, with BIS measurements obtained using an L-Dex U 400 device (Impedimed, Australia).
Measurements were obtained at baseline and at 3 to 6 weeks following final breast cancer surgery. Postoperative follow-up measurements occurred at 3 months and 6 months. Lymphedema diagnosis involved patient history, physical examination, and objective arm volume changes given by circumferential measurements and, with BIS, as L-Dex values.
Data were evaluated for 82 patients in this study. The mean patient age was 49.6 years (range, 27 to 65), and patients had a mean body mass index of 27.11 kg/m2. Breast cancer surgery involved mastectomy in 63.4% of the patients, and breast conservation therapy was used with 36.6%. The median number of excised lymph nodes was 10 (range, 2 to 28).
BIS enabled identification of subclinical/clinical lymphedema in 36.5% of patients at the 3-month follow-up and in 25.6% of patients at the 6-month follow-up. However, circumferential measurements enabled detection of subclinical/clinical lymphedema in 21.9% of patients at 3 months and 23.1% of patients at 6 months.
Regular periodic monitoring with BIS technology identified more patients with subclinical and/or clinical BCRL compared with circumferential volume measurements during the 6-month follow-up period, reported the study investigators.
The researchers considered the study’s findings to support prospective monitoring for BCRL, and they suggested use of BIS assessments should be a part of routine follow-up in patients receiving breast cancer surgery.
Borman P, Yaman A, Doğan L, et al. The comparative frequency of breast cancer-related lymphedema determined by bioimpedance spectroscopy and circumferential measurements. Eur J Breast Health. 2022;18(2):148-154. doi:10.4274/ejbh.galenos.2022.2021-9-2