Assessment of Breast Cancer-Related Lymphedema: A Comparison of Moisture Meter and Spot Bioimpedance Measurement

Czerniec, Sharon; Ward, Leigh C.; Kilbreath, Sharon

doi:10.1089/lrb.2014.0032

Cited by 23 publications

(11 citation statements)

References 33 publications

(63 reference statements)

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“… 35 Further development of both of these measurement techniques and correlation of results with imaging are important before translation into routine clinical practice. 36 On the other hand, water–fat MRI not only detects superficial tissue changes, but also changes in the whole composition of the extremity. Thus, water–fat MRI can possibly be used as a supplement to BIS and TDC in standardizing these methods, and in addition to analyze deep tissue changes before and after treatment.…”

Section: Discussionmentioning

confidence: 99%

Lymphedema Leads to Fat Deposition in Muscle and Decreased Muscle/Water Volume After Liposuction: A Magnetic Resonance Imaging Study

Hoffner

Peterson

Månsson

et al. 2018

Lymphatic Research and Biology

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Background: Lymphedema leads to adipose tissue deposition. Water–fat magnetic resonance imaging (MRI) can quantify and localize fat and water. The presence of excess fat and excess water/muscle in the subfascial compartment of the lymphedematous limb has not been investigated before. The aim of this study was to investigate epifascial and subfascial fat and water contents in patients with chronic lymphedema before and after liposuction.Methods and Results: Seven patients with arm lymphedema and six with leg lymphedema were operated on. The limbs were examined with water–fat MRI before liposuction (baseline) and at five time points. Complete reduction of the excess limb volumes was achieved. The excess epifascial fat was evident in the edematous limbs and a drop was seen following surgery. There were differences in excess water at all time points. At 1 year there was a decrease in excess water. Excess subfascial fat was seen in the edematous limbs at all time points. Subfascial excess water/muscle did not show any differences after surgery. However, starting from 3 months there was less subfascial water/muscle compared with baseline.Conclusions: Subfascial fat in the lymphedematous limbs did not change. In contrast, the water in the subfascial compartment was reduced over time, which may represent a decrease of muscle volume after treatment due to less mechanical load after liposuction. Using water–fat MRI-based fat quantification, the fat and water contents may be quantified and localized in the various compartments in lymphedema.

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Section: Discussionmentioning

confidence: 99%

Lymphedema Leads to Fat Deposition in Muscle and Decreased Muscle/Water Volume After Liposuction: A Magnetic Resonance Imaging Study

Hoffner

Peterson

Månsson

et al. 2018

Lymphatic Research and Biology

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“…Perometry, optical assessment of limb volume, is less time-consuming but more expensive. Tonometry is a noninvasive method that can detect subclinical interstitial edema via continuously measuring the dielectric constant in affected tissue and evaluating moisture content (88). BIS is more specific, but lacks sensitivity, and it may be the most frequently utilized modality (71).…”

Section: Diagnosis and Surveillancementioning

confidence: 99%

Lymphedema in survivors of breast cancer (Review)

et al. 2020

Oncol Lett

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The tremendous improvement of survival in patients with breast cancer can be attributed to several treatment strategies, but these strategies also lead to the occurrence of breast cancer-related lymphedema (BCRL). BRCL is regularly associated with factors such as axillary lymph node dissection and local lymph node radiotherapy and manifests as an increase of >10% in the volume of affected limbs. Being overweight or having obesity (body mass index ≥25 kg/m 2 ), an excessive number of positive lymph nodes (>8) and capsular invasion by a tumor are additional risk factors for lymphedema. It is worth assessing the risk before surgery as this can prevent the occurrence of BCRL at the initial stage of breast cancer management. The clinical utility of many diagnostic tools and lymphedema surveillance allows early stage and even subclinical BCRL to be diagnosed, and allows real-time monitoring of the disease. The early diagnosis of BRCL allows treatment at an early stage, which is beneficial to the reduction of excess limb volume and the improvement of quality of life. At present, the major therapeutic methods of BCRL include complex decongestive therapy, pneumatic compression devices, participating in exercise, microsurgery and liposuction, each of which alleviates lymphedema effectively. No medications for treatment of BRCL have yet been developed. However, the recent findings on the success of molecular therapy in animal models may remedy this deficiency. Furthermore, the volume reduction of swollen limbs without swelling rebound by transplanting autologous stem cells has been successfully reported in some pilot studies, which may provide a new technique for treating BCRL. This review aimed to discuss the pathogenesis, clinical manifestation, risk factors, advantages and disadvantages of diagnostic tools, lymphedema surveillance and the characteristics of traditional and newly emerging BCRL treatments.

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“…Volume of whole arm = sum of volumes of all segments of arm [22] (see figure 3) Material MoistureMeter D Compact (Delfin Technologies) [24][25][26] Reference points Deltoid, 5cm below lateral border of acromion Side of trunk, 5cm below axillary crease Method If skin is recently hydrated, dehydrate skin Sensor is placed perpendicular on the reference points with a pressure that is indicated by the device High electromagnetic wave is sent through the skin which will only be absorbed by water Degree of reflection/ water content can be read on the display of MoistureMeter D Ratio PWC = PWC healthy side / PWC affected side Change of stagnation of lymph at level of shoulder and trunk = Ratio PWC time 2 -Ratio PWC time 1…”

Section: Reference Pointsmentioning

confidence: 99%

Protocol of a randomised controlled trial regarding the effectiveness of fluoroscopy-guided manual lymph drainage for the treatment of breast cancer-related lymphoedema (EFforT-BCRL trial)

Vrieze

Vos

Gebruers

et al. 2018

European Journal of Obstetrics & Gynecology and Reproductiv

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A three-arm double-blinded randomised controlled trial will be conducted in different university hospitals in Belgium. Based on a sample size calculation, 201 participants with chronic BCRL stage 1 or 2 of the arm or hand, with at least 5% difference between both sides (corrected for hand dominance) need to be recruited. All participants receive the standard treatment: skin care, compression therapy and exercises. The intervention group additionally receives fluoroscopy-guided MLD. One control group additionally receives the traditional 'blind' MLD and a second control group receives a placebo MLD. All subjects receive 3 weeks of daily intensive treatments and 6 months of maintenance treatment. Follow-up period is 6 months. The primary outcomes are the reduction in lymphoedema volume of the arm/hand and the change in stagnation of lymph fluid at level of the shoulder/trunk.

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Assessment of Breast Cancer-Related Lymphedema: A Comparison of Moisture Meter and Spot Bioimpedance Measurement

Abstract: Both TDC and spot bioimpedance may have a role in clinical assessment of tissue compositional change in BCRL. Their relationship with tissue composition, assessed by imaging, is now required.

Cited by 23 publications

References 33 publications

Lymphedema Leads to Fat Deposition in Muscle and Decreased Muscle/Water Volume After Liposuction: A Magnetic Resonance Imaging Study

Lymphedema Leads to Fat Deposition in Muscle and Decreased Muscle/Water Volume After Liposuction: A Magnetic Resonance Imaging Study

Lymphedema in survivors of breast cancer (Review)

Protocol of a randomised controlled trial regarding the effectiveness of fluoroscopy-guided manual lymph drainage for the treatment of breast cancer-related lymphoedema (EFforT-BCRL trial)

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