A Randomized Trial Evaluating Bioimpedance Spectroscopy Versus Tape Measurement for the Prevention of Lymphedema Following Treatment for Breast Cancer: Interim Analysis

Ridner, Sheila H.; Dietrich, Mary S.; Cowher, Michael S.; Taback, Bret; McLaughlin, Sarah A.; Ajkay, Nicolás; Boyages, John; Koelmeyer, Louise; DeSnyder, Sarah M.; Wagner, Jamie L.; Abramson, Vandana G.; Moore, Andrew; Shah, Chirag

doi:10.1245/s10434-019-07344-5

Cited by 60 publications

(82 citation statements)

References 21 publications

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“…While studies have shown a lower incidence in lymphedema severity amongst breast cancer patients after treatment when undergoing early surveillance with BIS compared to a traditional referral model of care [ 30 ], there are no reports directly comparing the efficacy of early surveillance models leveraging BIS versus using limb volume changes. BIS has only been found to have modest correlation to Perometer, with one study finding R = 0.60 [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients

et al. 2020

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Background Lymphedema is a common complication of breast cancer treatment that affects one in five breast cancer survivors, yet there is no reliable method to detect lymphedema in the subclinical range. The objective of this study was to determine the feasibility and reliability of using an infrared 3D scanning device (ISD) as a peri-operative limb volume measurement tool. Methods Fifteen patients were analyzed based on inclusion criteria. Peri-operative measurements were obtained using tape measure and an ISD. Volumes were calculated using a standard algorithm for tape measure and a custom algorithm for ISD measurements. Linear regression models were used to assess ISD and tape measurement volume and circumference correlation. One-way ANOVA was used to compare change in percent difference at set time points post-operatively (2–3 weeks, 4–6 weeks, and 7–12 weeks) for both ISD and tape measure. t tests for unequal variances with the Bonferroni correction were performed among these groups. Results There is a positive linear correlation (R2 = 0.8518) between absolute volume measurements by the ISD and tape measure. Analyses over 2–10 weeks post-operatively showed that the ISD was able to detect volume changes in both the unaffected and the affected arm. Furthermore, the affected arm tended to have a greater increase in volume in the majority of patients, indicating these patients could be at risk for lymphedema. Conclusions Technology utilizing infrared 3D scanners can reliably measure limb volume pre- and post-treatment similarly to tape measure in a small sample of patients. Further research using 3D scanning technology with a longer follow up is warranted.

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Section: Discussionmentioning

confidence: 99%

An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients

et al. 2020

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“…The included studies also highlight the need for reliable measurements and definitions of subclinical lymphedema. Both percentage increase compared to pre-surgery measurements [16,18,19] as well as increase in volume difference between the limbs were applied [5]. However, by long-term follow-up volume difference between the limbs always has to be taken into account, due to body weight change and thereby normal change of limb volume.…”

Section: Discussionmentioning

confidence: 99%

“…Recent findings from a randomized, controlled trial (n ¼ 508) evaluating the effect of prospective lymphedema surveillance on lymphedema incidence, comparing the use of bioimpedance spectroscopy (BIS) versus tape measure (TM) to investigate early lymphedema treatment (compression sleeve) also provide some insight into the potential role of compression as tertiary prevention [19]. This trial implemented compression sleeves for a minimum of 4 weeks for those women whose BIS or TM measurements exceeded their preclinical lymphedema threshold.…”

Section: Tertiary Preventionmentioning

confidence: 99%

Prevention of arm lymphedema through the use of compression sleeves following breast cancer: results from a targeted literature review

Johansson

Ochałek

Hayes

2020

Physical Therapy Reviews

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Background: Breast cancer-related lymphedema (BCRL) is associated with impaired function and poorer quality of life. BCRL is also considered time-consuming and costly to treat. While compression treatment is considered the most efficient and effective form of treatment for early BCRL, its impact on the lymphatic system highlights its potential in the prevention of lymphedema. Objectives: To identify and summarise studies evaluating compression garment as a prevention strategy for BCRL. Methods: This is a targeted literature review of studies that evaluated use of compression garment in the prevention of BCRL, including prevention post-surgery and prevention of progression of subclinical lymphedema. Results: A total of 4 studies were identified that assessed the role of compression garment in the secondary (one randomized, controlled trial; n ¼ 45) or tertiary (three cohort studies; sample size range: 111-508) prevention of BCRL. Together, findings from these studies suggest that use of compression garment was associated with reduced incidence, attenuation of lymphedema or prevention of progression to more severe lymphedema. However, the absence of a randomized, controlled trial in the tertiary setting means causal inferences relationship cannot be made. Conclusion: There is significant scope for further research, with consideration of possible benefits and costs associated with differences in compression class, duration or daily wear time, as well as comparison to other preventive strategies including patient preferences.

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“…Alternatively, this ratio may be linearised and expressed as an L-Dex score with the normal range being between − 10 and + 10 [ 22 ]. A change of + 6.5 L-Dex units from baseline is considered a trigger of sub-clinical lymphoedema [ 19 , 29 ]. This device is portable and can be operated easily by an individual completing self-measurements within a home environment with access to power and a wireless internet network.…”

Section: Methodsmentioning

confidence: 99%

“…A prospective surveillance and early intervention model of care has been recognised as an optimal framework for the early detection and management of sub-clinical lymphoedema [ 13 – 15 ]. Using prospective surveillance model in clinical practice enables the early identification and intervention for lymphoedema, sometimes in a sub-clinical stage, where intervention can prevent progression to a chronic condition [ 16 – 19 ]. Recommended practice for the prospective surveillance model requires that individuals at risk of lymphoedema regularly attend clinics on a 3–6 monthly cycle according to their risk factors and treatment pathway for three years to have their arm monitored for lymphoedema by either using bioimpedance spectroscopy (BIS) or circumference measurements [ 13 , 16 ]…”

Section: Appendixmentioning

confidence: 99%

Prospective surveillance model in the home for breast cancer-related lymphoedema: a feasibility study

Koelmeyer

Moloney

Boyages

et al. 2020

Breast Cancer Res Treat

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The aim of this study was to assess the feasibility of delivering a prospective surveillance model in the home over 6 months for women at high risk of developing lymphoedema. Methods A single-group, intervention study recruited 20 women who had surgical and medical treatment for confirmed node-positive invasive breast cancer and therefore at high risk of developing arm lymphoedema. Participants received a package including Bioimpedance Spectroscopy (BIS) monitoring, lymphoedema education and support to promote selfmanagement and physical activity. Results Participants adhered to BIS monitoring 74% of the time, and felt extremely confident in using the device. By 6 months, mean BIS L-Dex scores had increased from 3.5 (SD 5.6) to 8.4 (SD 11.1); five women (25%) who experienced > + 6.5 increase in L-Dex score were fitted with a compression garment. Self-reported symptoms and distress decreased by 0.4 out of 10 (95% CI 0.1 to 0.7); number of self-management strategies used increased by 0.6 (95% CI 0.1 to 1.2); and planned exercise increased by 2.8 h/week (95% CI 0.4 to 5.2). Conclusions These findings indicate a prospective surveillance model of care in the home with BIS is feasible and associated with increased self-management. A Phase II randomised trial is warranted as well as research exploring the costs associated with implementing this model of care for high-risk individuals.

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A Randomized Trial Evaluating Bioimpedance Spectroscopy Versus Tape Measurement for the Prevention of Lymphedema Following Treatment for Breast Cancer: Interim Analysis

Cited by 60 publications

References 21 publications

An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients

An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients

Prevention of arm lymphedema through the use of compression sleeves following breast cancer: results from a targeted literature review

Prospective surveillance model in the home for breast cancer-related lymphoedema: a feasibility study

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