Utilization of bioelectrical impedance analysis for detection of lymphedema in breast Cancer survivors: a prospective cross sectional study

Sung Mook Lim, Yujin Han, Seung Il Kim, Hyung Seok Park, Sung Mook Lim, Yujin Han, Seung Il Kim, Hyung Seok Park

Abstract

Background: Breast cancer survivors are at risk of developing breast cancer-related lymphedema (BCRL) after surgical treatment, which may have a negative effect on quality of life. The purpose of this study was to investigate the clinical role of bioelectrical impedance analysis (BIA) and the relationship between the development of BCRL in breast cancer survivors who have undergone axillary surgery.

Methods: A total of 228 patients with breast cancer were enrolled in the study between May 2016 and January 2017. BCRL was assessed by measuring the circumference of both arms at 15 cm below the acromion process and the olecranon process. Patients were classified as BCRL (n = 22) and non-BCRL (n = 206) based on the difference of the arm circumference of 2 cm. Data including lymphedema, anthropometry, BIA measurements, food frequency questionnaire, type of surgery, total number of dissected lymph nodes, and post-operative treatment were collected.

Results: Of the breast cancer survivors, 10.4% had BCRL by the definition. The BCRL group contained 22 patients, while the non-BCRL group contained 206 patients. Compared to the non-BCRL group, the BCRL group had a higher body mass index, a larger percentage of ideal body weight, more dissected lymph nodes, and higher single frequency BIA (SFBIA) ratio (P = 0.027, P = 0.031, P < 0.001, and P < 0.001, respectively). The SFBIA ratio provided 63.64% sensitivity and 95.15% specificity in estimating the risk of BCRL.

Conclusion: Our data provides evidence to support that the use of SFBIA ratio can serve as an alternative method to monitor and/or diagnose BCRL.

Trial registration: This trial was retrospectively registered at Clinicaltrials.gov identifier ( NCT03391206 ) on the 5 January 2018.

Keywords: Axillary lymph node dissection; BMI; Bioelectrical impedance; Breast cancer related lymphedema; Sentinel lymph node biopsy.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart illustrating the classification of the study participants in breast cancer survivors
Fig. 2
Fig. 2
ROC curve of the 1 kHz and 5 kHz SFBIA ratio value. After the breast cancer surgery, the 1 kHz and 5 kHz SFBIA ratio of the survivors showed the good test performance to detect lymphedema with an area under the curve of 0.74 (95% CI: 0.59–0.89) and 0.77 (95% CI: 0.63–0.90), respectively. The 1 kHz and 5 kHz SFBIA ratio were effective predictors of post–BCRL(p = 0.000, p = 0.000)

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