CORRELATION AMONG BIOIMPEDANCE ANALYSIS, SONOGRAPHIC AND CIRCUMFERENTIAL MEASUREMENT IN ASSESSMENT OF BREAST CANCER-RELATED ARM LYMPHEDEMA

Abstract

New approaches for assessment oflymphedema using ultrasonography (US) havebeen introduced recently and are reported tobe reliable and simple. Ultrasonographyprovides detailed information about physicalproperties of the tissue in addition to volumeand size. There have been only limited studiescomparing bioimpedance analysis (BIA), US,and circumferential measurement (CM),which is considered a standard measurement.The aim of this study was to determine therelationship between US, BIA, and CM.Twenty-eight patients with lymphedema afterbreast cancer surgery underwent BIA, US,and CM. Impedance, which reflects theamount of extracellular fluid, was measuredwith 1 kHz frequency in affected andunaffected arms. Circumferences weremeasured at 10cm proximal and distal to theelbow and a truncated cone method used tocalculate estimated volumes for upper armand forearm. We found that interlimb forearmsubcutis thickness differences measured byUS were highly correlated with CM measurementsand that interlimb upper arm subcutisthickness differences measured by US weremoderately correlated with CM measurementsand BIA ratios. However, the interlimb ratioof compressibility measured by US showed noor only weak correlation with impedance measurementsand circumferential measurements.Our results also show that compressibilitymeasured by US could not be predicted fromBIA or CM measurements despite a highdegree of concordance among subcutisthickness measured by US, CM, and BIA.