A prospective validation study of bioimpedance with volume displacement in early-stage breast cancer patients at risk for lymphedema Journal Article
| Authors: | Barrio, A. V.; Eaton, A.; Frazier, T. G. |
| Article Title: | A prospective validation study of bioimpedance with volume displacement in early-stage breast cancer patients at risk for lymphedema |
| Abstract: | Background: Although volume displacement (VD) is considered the gold standard for diagnosing breast cancer-related lymphedema, it is inconvenient. We compared bioimpedance (L-Dex) and VD measurements in a prospective cohort of breast cancer patients at risk for lymphedema. Methods: Between 2010 and 2014, a total of 223 breast cancer patients were enrolled. Following exclusions (n = 37), 186 received baseline VD and L-Dex; follow-up measurements were performed at 3–6 months intervals for 3 years. At each visit, patients fitted into one of three categories: normal (normal VD and L-Dex); abnormal L-Dex (L-Dex > 10 or increase in 10 from baseline and normal VD); or lymphedema (relative arm volume difference of >10 % by VD ± abnormal L-Dex). Change in L-Dex was plotted against change in VD; correlation was assessed using the Pearson correlation. Results: At a median follow-up of 18.2 months, 152 patients were normal, 25 had an abnormal L-Dex, and 9 developed lymphedema without a prior L-Dex abnormality. Of the 25 abnormal L-Dex patients, 4 progressed to lymphedema, for a total of 13 patients with lymphedema. Evaluating all time points, 186 patients had 829 follow-up measurements. Sensitivity and specificity of L-Dex compared with VD were 75 and 93 %, respectively. There was no correlation between change in VD and change in L-Dex at 3 months (r = 0.31) or 6 months (r = 0.21). Conclusions: VD and bioimpedance demonstrated poor correlation with inconsistent overlap of measurements considered abnormal. Of patients with an abnormal L-Dex, few progressed to lymphedema; most patients with lymphedema did not have a prior L-Dex abnormality. Further studies are needed to understand the clinical significance of bioimpedance. © 2015, Society of Surgical Oncology. |
| Keywords: | adult; controlled study; aged; major clinical study; cancer patient; comparative study; outcome assessment; follow up; prospective study; sensitivity and specificity; controlled clinical trial; breast cancer; cohort analysis; validation study; risk factor; lymphedema; early cancer; extracellular fluid; non invasive procedure; extracellular space; predictive value; diagnostic equipment; human; female; article; bioimpedance device; fluid shift; volume displacement |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 22 |
| Issue: | Suppl. 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2015-12-01 |
| Start Page: | 370 |
| End Page: | 375 |
| Language: | English |
| DOI: | 10.1245/s10434-015-4683-0 |
| PROVIDER: | scopus |
| PMCID: | PMC4684482 |
| PUBMED: | 26085222 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 February 2016 -- Source: Scopus |
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