Breast Edema in Patients Undergoing Breast-Conserving Treatment for Breast Cancer: Assessment via High Frequency Ultrasound

Abstract

To identify factors that can influence breast edema in women undergoing breast-conserving therapy. Breast edema was assessed clinically and via high frequency ultrasound (HFUS) prior to, during and following radiotherapy. Fifty-four women were assessed. Breast edema was present prior to radiotherapy in patients who had undergone level 2 node dissection or had wound infection after sentinel node dissection. Edema increased during and after radiotherapy and peaked at 4-6 months. The time course of breast edema was related to the extent of nodal dissection, postoperative wound infection and regional radiotherapy. HFUS prior to irradiation was found to be no better than clinical assessment in predicting prolonged parenchymal breast edema but was significantly better at the end of irradiation. Breast edema levels are minimal in patients who do not undergo axillary node dissection or have an uncomplicated sentinel node dissection. Most edema is due to compromise of the draining lymphatics, which relates largely to the extent of axillary node dissection. HFUS appears to be a useful in the research setting in quantifying the effect of techniques that aim to reduce complications such as edema.

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

“…Recent studies with ultrasound are promising and may provide a comparator for determination of trunk swelling. 38,39 Advantages of ultrasound include no radiation exposure, low cost, and increasing availability in clinical settings. 40,41 Ultrasound also measures tissue in a transverse direction, 7 similar to TDC and bioimpedance spot measures.…”

A prospective study of breast lymphedema: frequency, symptoms, and quality of life

“…Finally, medical records of all patients meeting our case definition of breast lymphedema were examined to corroborate the study nurse’s impression with the clinical observations and diagnoses of providers separate from the study. Recent preliminary data [3, 18, 19] suggest that both ultrasound and bioimpedance may be useful modalities in the diagnosis of breast lymphedema. Further evaluation is ongoing to compare these two tools with clinical exams and patient reported outcomes.…”

Radiation-induced morbidity evaluated by high-frequency ultrasound

“…Study designs have correlated HFUS/US findings with single [2] or combined [3] morbidity endpoints, tested for predictive value of edema development [4] or simply stated if there was a difference between irradiated and non-irradiated breasts [5,6].…”