Lymphedema is an accumulation of lymph fluid in the limb resulting
from an insufficiency of the lymphatic system. It is commonly
associated with surgical or radiotherapy treatment for breast
cancer. As with many progressively debilitating disorders, the
effectiveness of treatment is significantly improved by earlier
intervention. Multiple frequency bioelectrical impedance analysis
(MFBIA) previously was shown to provide accurate relative measures
of lymphedema in the upper limb in patients after treatment
for breast cancer. This presentation reports progress to date
on a three-year prospective study to evaluate the efficacy of
MFBIA to predict the early onset of lymphedema in breast cancer
patients following treatment. Bioelectrical impedance measurements
of each upper limb were recorded in a group of healthy control
subjects (
n = 50) to determine the ratio of extracellular limb-fluid
volumes. From this population, the expected normal range of
asymmetry (99.7% confidence) between the limbs was determined.
Patients undergoing surgery to treat breast cancer were recruited
into the study, and MFBIA measurements were recorded presurgery,
at one month and three months after surgery, and then at two-month
intervals for up to 24 months postsurgery. When patients had
an MFBIA measure outside the 99.7% range of the control group,
they were referred to their physician for clinical assessment.
Results to date: Over 100 patients were recruited into the study
over the past two years; at present, 19 have developed lymphedema
and, of these, 12 are receiving treatment. In each of these
19 cases, MFBIA predicted the onset of the condition up to four
months before it could be clinically diagnosed. The false-negative
rate currently is zero. The study will continue to monitor patients
over the remaining year to accurately ascertain estimates of
specificity and sensitivity of the procedure.
