COMPARISON OF PEROMETRY-BASED VOLUMETRIC ARM MEASUREMENTS AND BIOIMPEDANCE SPECTROSCOPY FOR EARLY IDENTIFICATION OF LYMPHEDEMA IN A PROSPECTIVELY-SCREENED COHORT OF BREAST CANCER PATIENTS

Abstract

Breast cancer-related lymphedema
(BCRL) affects more than one in five women
treated for breast cancer, and women remain at
lifelong risk. Screening for BCRL is recommended
by several national and international
organizations for women at risk of BCRL, and
multiple methods of objective screening measurement
exist. The goal of this study was to
compare the use of perometry and bioimpedance
spectroscopy (BIS) for early identification
of BCRL in a cohort of 138 prospectivelyscreened
patients. At each screening visit, a
patient's relative volume change (RVC) from
perometer measurements and change in L-Dex
from baseline (ΔL-Dex) using BIS was
calculated. There was a negligible correlation
between RVC and ΔL-Dex (r=0.195). Multiple
thresholds of BCRL were examined: RVC ≥5%
and ≥10% as well as and ΔL-Dex ≥6.5 and ≥10.
While some patients developed an elevated
RVC and ΔL-Dex, many demonstrated
elevations in only one threshold category.
Moreover, the majority of patients with RVC
≥5%, ΔL-Dex ≥6.5, or ΔL-Dex ≥10 regressed to
non-elevated measurements without intervention.
These findings suggest a role for
combining multiple screening methods for early
identification of BCRL; furthermore, BCRL
diagnosis must incorporate patient symptoms
and clinical evaluation with objective measurements
obtained from techniques such as
perometry and bioimpedance spectroscopy.