Bioelectrical impedance for detecting and monitoring patients for the development of upper limb lymphedema in the clinic.

BACKGROUND

Single-frequency bioelectrical impedance (BI) has been used to measure extracellular fluid in the upper limbs. The purpose of the study was to evaluate BI's ability to detect and monitor upper limb changes in based upon the extent of various treatments and to assess its practicality.

METHODS

Patients with newly diagnosed breast cancer were evaluated at baseline and after procedures that could potentially affect fluid accumulation in the arm and signal the possible development of early lymphedema. The magnitude of the change in lymphedema index ratios (LIR) from these procedures was evaluated to determine the sensitivity of BI.

RESULTS

A total of 64 patients were evaluated. Although no difference in LIRs was noted by the extent of surgical procedure (lumpectomy 2.1 vs. mastectomy 1.1; P = .49), a trend was noted for increased LIRs with more aggressive axillary staging when sentinel lymph node was compared with axillary lymph node dissection (1.3 vs. 3.4; P = .08). A trend for an increased LIR with more aggressive local therapy also was noted when using a cutoff of less than 4 lymph nodes sampled compared with 4 or more nodes sampled (1.2 vs. 2.6; P = .09).

CONCLUSIONS

In this limited analysis, L-Dex readings paralleled the extent of surgical interventions and suggest that they can be used to monitor patients for the early onset of edema. Further studies are needed to help validate the extent, degree, and chronologic time frame of these changes to help define recommendations for closer monitoring of patients and possible early intervention.