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03-08-2023 | Lymphedema | Breast Oncology

Breast Cancer-Related Lymphedema (BCRL) and Bioimpedance Spectroscopy: Long-Term Follow-Up, Surveillance Recommendations, and Multidisciplinary Risk Factors

Authors: Elizabeth J. Jeffers, MD, Jamie L. Wagner, DO, MBA, Sabrina S. Korentager, MSN, CLT-UE, Kelsey E. Larson, MD, Christa R. Balanoff, MD, Jordan Baker, MS, Lynn Chollet-Hinton, PhD, MSPH, Lyndsey J. Kilgore, MD

Published in: Annals of Surgical Oncology | Issue 10/2023

Abstract

Background

Early detection and intervention for breast cancer-related lymphedema (BCRL) significantly decreases progression to persistent BCRL (pBCRL). We aimed to provide long-term follow-up on our early detection with bioimpedance spectroscopy (BIS) and early home intervention demonstrating reduced pBCRL to guide surveillance recommendations.

Patients and Methods

In total, 148 female patients with breast cancer who had axillary lymph node dissection (ALND) from November 2014 to December 2017 were analyzed. Baseline BIS measurements and postoperative follow-up occurred every 3 months for 1 year, biannual for 1 year, and then annually. An elevated BIS triggered evaluation and initiation of at-home interventions with reassessment for resolution versus persistent BCRL (pBCRL). High-risk factors and timing were analyzed.

Results

Mean follow-up was 55 months, and 65 (44%) patients had an abnormal BIS. Of these, 54 (82%) resolved with home intervention. The overall pBCRL rate was 8%. Average time to first abnormal BIS was 11.7 months. None of the stage 0 patients (0/34) and only 5/25 (20%) of stage 1 patients had pBCRL. All of stage 2 and stage 3 patients (7/7) had pBCRL. pBCRL correlated with number of positive nodes, percentage of positive nodes, stage of lymphedema at diagnosis, and recurring abnormal BIS measurements (p < 0.05).

Conclusions

We have shown that patients undergoing ALND with early BCRL identified by BIS who performed home interventions had an 8% pBCRL rate. Patients at high risk for pBCRL should have routine surveillance starting at 9 months postoperatively to identify an opportunity for early intervention.

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Title: Breast Cancer-Related Lymphedema (BCRL) and Bioimpedance Spectroscopy: Long-Term Follow-Up, Surveillance Recommendations, and Multidisciplinary Risk Factors
Authors: Elizabeth J. Jeffers, MD
Jamie L. Wagner, DO, MBA
Sabrina S. Korentager, MSN, CLT-UE
Kelsey E. Larson, MD
Christa R. Balanoff, MD
Jordan Baker, MS
Lynn Chollet-Hinton, PhD, MSPH
Lyndsey J. Kilgore, MD
Publication date: 03-08-2023
Publisher: Springer International Publishing
Keywords: Lymphedema
Breast Cancer
Breast Cancer
Published in: Annals of Surgical Oncology / Issue 10/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-023-13956-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Breast Cancer-Related Lymphedema (BCRL) and Bioimpedance Spectroscopy: Long-Term Follow-Up, Surveillance Recommendations, and Multidisciplinary Risk Factors

Abstract

Background

Patients and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and Methods

Results

Conclusions

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