Confirmation of the Reference Impedance Ratios Used for Assessment of Breast Cancer-Related Lymphedema by Bioelectrical Impedance Spectroscopy

Ward, Leigh C.; Dylke, Elizabeth; Czerniec, Sharon; Isenring, Elisabeth; Kilbreath, Sharon L.

doi:10.1089/lrb.2010.0014

Cited by 117 publications

(96 citation statements)

References 13 publications

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“…BIS arm measurements were completed as previously described [14] using an SBF7 impedance spectrometer (Impedimed Ltd, Brisbane, Qld, Australia). All BIS files were processed using software supplied by the manufacturer (Bioimp v.5.2.4.0, Impedimed Ltd.) and the impedance at zero resistance (R 0 ) determined.…”

Section: Clinical Measurementsmentioning

confidence: 99%

“…Normatively determined thresholds set at 2SD and 3SD above the mean of a control population were evaluated for arm volume, circumference [8] and BIS [6,14] measurements. As limb dominance significantly affects limb volume and circumference [8] as well as BIS measurements, different thresholds were used depending on dominance of the arm affected or at risk.…”

Section: Diagnostic Cut-offsmentioning

confidence: 99%

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Diagnosis of upper limb lymphedema: development of an evidence-based approach

et al. 2016

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Background: The diagnosis of secondary upper limb lymphedema (LE) is complicated by the lack of an agreed-upon measurement tool and diagnostic threshold. The aim of this study was to determine which of the many commonly used and normatively determined clinical diagnostic thresholds has the best diagnostic accuracy of secondary upper limb LE, when compared to diagnosis by an appropriate reference standard, lymphoscintigraphy. Material and methods: The arms of women treated for breast cancer with and without a previous diagnosis of LE, as well as healthy controls, were assessed using lymphoscintigraphy, bioimpedance spectroscopy (BIS) and perometry. Dermal backflow score determined from lymphoscintigraphy imaging assessment (reference standard) was compared with diagnosis by both commonly used and normatively determined diagnostic thresholds for volume and circumference measurements as well as BIS. Results: For those with established dermal backflow, all commonly used and normatively determined diagnostic thresholds accurately identified presence of LE compared with lymphoscintigraphy diagnosis. In participants with mild to moderate changes in dermal backflow, only a normatively determined diagnostic threshold, set at two standard deviations above the norm, for arm circumference and full arm BIS were found to have both high sensitivity (81% and 76%, respectively) and specificity (96% and 93%, respectively). For this group, strong, and clinically useful, positive (23 and 10, respectively) and negative likelihood (0.2 and 0.3) ratios were found for both the circumference and bioimpedance diagnostic thresholds. Conclusion: For the first time, evidence-based clinical diagnostic thresholds have been established for secondary LE. With mild LE, normatively determined circumference and BIS thresholds are superior to the commonly used thresholds.

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Section: Clinical Measurementsmentioning

confidence: 99%

Section: Diagnostic Cut-offsmentioning

confidence: 99%

Diagnosis of upper limb lymphedema: development of an evidence-based approach

et al. 2016

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“…[22][23][24][25] BIA has been shown to be more sensitive, reliable, and valid than tape measurement of the limb and has been used in multiple research studies. [22][23][24] The FDA has approved a single frequency bioelectrical impedance analysis (SFBIA) device to measure lymphedema, the Impedimed L-Dex XCA.…”

Section: Introductionmentioning

confidence: 99%

Bioelectrical Impedance Self-Measurement Protocol Development and Daily Variation Between Healthy Volunteers and Breast Cancer Survivors with Lymphedema

Ridner

Bonner

Doersam

et al. 2014

Lymphatic Research and Biology

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Background: A significant percentage of breast cancer survivors are at risk for lymphedema for which lifelong self-care is required. Previous studies suggest that less than 50% of breast cancer survivors with lymphedema (BCS-LE) perform prescribed self-care tasks and that even wearing a compression sleeve, the most commonly reported self-care activity, is done irregularly. Reasons for poor self-care adherence include perceived lack of results from self-care (no available arm volume data) and perceived inability to manage the condition. Methods and Results: A two-part pilot study was conducted to: 1) develop and determine the feasibility of a selfmeasurement protocol using a single frequency bioelectrical impedance device; and 2) examine daily variation in extracellular volume in healthy and lymphedematous limbs. Healthy and BCS-LE volunteers were recruited to refine and test a self-measurement protocol. Volunteers were trained in the use of the device and measured for 5 consecutive days in a laboratory setting. They were then given the device to use at home for an additional 5 consecutive days of self-measurement. All volunteers completed each scheduled home measurement. Daily variability in both groups was noted. Conclusions: Home self-measurement using bioelectrical impedance is feasible, acceptable, and captures change. This has implications for both self-care support and for the possibility of incorporating self-measurement using bioelectrical impedance in future clinical trials examining effectiveness of lymphedema treatment.

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“…Deficits in nutrition have a significant impact on mortality, morbidity, and quality of life in patients with hnc 2-4 . Bioelectrical impedance analysis (bia) has been established as a valuable tool in the evaluation of body composition and nutrition status in many conditions, including cancer [5][6][7][8][9] . Parameters of nutrition status (for example, weight change, mid-arm muscle circumference, triceps skin fold thickness) or laboratory measurements are unstable in cancer patients in the clinical setting 10 .…”

Section: Introductionmentioning

confidence: 99%

Extracellular–to–Body Cell Mass Ratio and Subjective Global Assessment in Head-and-Neck Cancers

2014

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Background: The ratio of extracellular mass to body cell mass (ecm/bcm), determined by bioelectrical impedance analysis, has been found to be a potentially useful indicator of nutrition status. Subjective global assessment (sga) is a subjective method of evaluating nutrition status in head-and-neck cancer. The present study was conducted to investigate the association between ecm/bcm and sga in head-and-neck cancer. Methods: Patients were classified as either well-nourished or malnourished by sga. Bioelectrical impedance analysis was conducted on a population of 75 patients with histologically confirmed head-and-neck cancer, and the ecm/bcm was calculated. Receiver operating characteristic curves were estimated using the nonparametric method to determine an optimal cut-off value of the ecm/bcm. Results: Compared with malnourished patients, those who were well-nourished had a statistically significantly lower ecm/bcm (1.11 vs. 1.28, p = 0.005). An ecm/bcm cut-off of 1.194 was 76% sensitive and 63% specific in detecting malnutrition. Conclusions: The ecm/bcm can be an indicator that detects malnutrition in patients with head-and-neck cancer. Further observations are needed to validate the significance of the ecm/bcm and to monitor nutrition interventions.

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Confirmation of the Reference Impedance Ratios Used for Assessment of Breast Cancer-Related Lymphedema by Bioelectrical Impedance Spectroscopy

Abstract: The impedance ratio thresholds for early detection of lymphedema remain suitable for clinical use with present day bioimpedance spectroscopy analyzers and measurement protocols.

Cited by 117 publications

References 13 publications

Diagnosis of upper limb lymphedema: development of an evidence-based approach

Diagnosis of upper limb lymphedema: development of an evidence-based approach

Bioelectrical Impedance Self-Measurement Protocol Development and Daily Variation Between Healthy Volunteers and Breast Cancer Survivors with Lymphedema

Extracellular–to–Body Cell Mass Ratio and Subjective Global Assessment in Head-and-Neck Cancers

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