Baseline and early postoperative bioimpedance spectroscopy and perometry measurements in patients treated for breast cancer: insights from a prospective screening program.

PURPOSE: To describe bioimpedance spectroscopy (BIS) L-Dex values at breast cancer (BC) diagnosis and within the first year post-surgery in a cohort prospectively screened for breast cancer-related lymphedema (BCRL). We also aim to explore BCRL diagnostic overlap utilizing perometry and BIS thresholds.

METHODS

Patients undergoing treatment for unilateral BC were prospectively assessed for subclinical BCRL using BIS and perometry at preoperative baseline and during follow-up. Normal baseline scores were considered an absolute arm volume difference < 5% and an L-Dex score between -10 and + 10. BCRL was defined as relative volume change (RVC) ≥ 5% via perometry or L-Dex > 6.5 increase from preoperative baseline during follow-up.

RESULTS

The study cohort included 490 patients who underwent same-day perometry and BIS measurements at preoperative baseline, 306 of whom had same-day measurements postoperatively. At baseline, 99 patients (20.2%) had an absolute arm-volume difference ≥ 5%, and 39 patients (8.0%) had an L-Dex value > 6.5. Among patients with follow-up data (N = 306), 36 (11.8%) were diagnosed with BCRL using one or both tools. Of these, 16 patients (44.4%) were diagnosed by RVC-only, 17 (47.2%) by BIS-only, and 3 (8.3%) by both methods. Kaplan-Meier estimates for BCRL at 1, 2, and 3 years were 7.6%, 8.5% and 8.5% for RVC-only; 5.7%, 8.0%, and 15% for BIS-only; and 15%, 18%, and 25% via any method.

CONCLUSION

Although BIS and perometry detected a comparable percentage of subclinical BCRL cases, they identified different individuals, indicating that combining both methods may increase case detection. Preoperative baseline measurements are imperative.