Introduction: Early detection and treatment of upper-limb lymphoedema following axillary surgery for breast cancer can reduce symptomatic disease. Bioimpedance spectroscopy (BIS) can be used to identify increased extracellular fluid volume.
Aim: The aim of this study was to determine the rates of lymphoedema identified by prospective surveillance with BIS and the effects of early identification on patient outcomes.
Methods: Patients undergoing axillary surgery for breast cancer had BIS measurements recorded pre-operatively and quarterly for 1 year to assess any changes or development of clinical signs of lymphoedema. A reading indicating an increase in extracellular fluid volume led to treatment with a compression sleeve, skincare management and exercise as per departmental protocol.
Results: 354 patients were included in the final analysis and mean follow up was 50 months. Of these, 10.7% (n=38) of patients had an abnormal BIS reading indicating early lymphoedema, while a subset of 6.5% (n=23) of patients required referral to specialist lymphoedema services. Of patients who underwent early treatment, 58.8% (n=20) did not require any further long-term management.
Conclusions: Abnormal (ratio values above the normal range, or values that have changed by at least 10 units from the baseline) BIS is a significant predictor for developing lymphoedema. This can be utilised in a prospective surveillance model, to direct early therapy and potentially reduce the incidence of clinically significant lymphoedema, however, further randomised controlled studies would be required to confirm this.
