Bioimpedance spectroscopy (BIS) with L-Dex measurements. for lymphedema – pro
Breast cancer-related lymphedema (BCRL) is an increasingly diagnosed complication of breast cancer treatment with incidence rates of 5% with lumpectomy alone to more than 40% with mastectomy, axillary dissection, and radiation therapy. Increasing data support the role of early detection and treatment with one diagnostic modality being bioimpedance spectroscopy (BIS) with L-Dex measurements.
A recent systematic review by Shah et al. concluded that multiple randomized and prospective trials have been performed evaluating early detection of BCRL and have demonstrated reduced rates of BCRL with such an approach.BCRL surveillance programs should focus on high-risk patients including those undergoing mastectomy, axillary lymph node dissection, sentinel node biopsy with greater than six nodes sampled, regional nodal irradiation, and those requiring taxane-based chemotherapy. Patients should undergo assessment prior to locoregional therapy and then every 3 months for the first 3 years with additional measurements made based on clinical assessment. A change in L-Dex of 10 has been utilized has a consistent trigger to initiate BCRL treatment.
Chirag Shah, Frank A. Vicini, Douglas W. Arthur, Bioimpedance spectroscopy for lymphedema assessment: Clinical practice guidelines. Journal of Clinical Oncology 34, no. 3_suppl (January 2016) 146-146.
David I. Kaufman, Chirag Shah,Frank A. Vicini, Marisa Rizzi,Utilization of bioimpedance spectroscopy in the prevention of chronic breast cancer-related lymphedema.
Breast Cancer Research and Treatment December 2017, Volume 166, Issue 3, pp 809815