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Is bioimpedance spectroscopy a useful tool for objectively assessing lymphovenous bypass surgical outcomes in breast cancer-related lymphedema?

Breast Cancer Research and Treatment volume 186, pages 1–6 (2021)Cite this article

Abstract

Purpose

We sought to determine if bioimpedance spectroscopy (BIS) measurements can accurately assess changes in breast cancer-related lymphedema (BCRL) in patients undergoing lymphovenous bypass (LVB).

Methods

Patients undergoing LVB for BCRL refractory to conservative treatment from 1/2015 to 12/2018 were identified from an IRB-approved prospectively maintained database at a single institution. All breast cancer patients were assessed with baseline BIS measurements prior to any oncologic surgery and serial BIS during follow-up office visits including before and after LVB. Clinicopathologic information, LVB operative details, and pre- and post-LVB operative BIS measurements were collected. Analysis focused on clinically significant BIS change, defined as two standard deviations (SD), and comparing LVB anastomosis to BIS changes.

Results

During the study timeframe, nine patients underwent LVB for treatment of BCRL. The majority (78%) received radiation, taxane chemotherapy, and underwent axillary dissection. An average of 5.6 LVB anastomoses were performed per patient. The average change in BIS following LVB was a 3SD reduction, indicating a clinically significant change. This improvement was stable over time, with persistent 2SD reduction at 22 months postoperatively. The number of LVB anastomoses performed did not significantly correlate with the degree of BIS change.

Conclusions

This is the first study to utilize BIS measurements to assess response to LVB surgical intervention for BCRL. BIS measurements demonstrated clinically significant improvement after LVB, providing objective evidence in support of this surgical treatment for BCRL. BIS changes should be reported as key objective data in future studies assessing BCRL interventions, including response to LVB.

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Acknowledgements

The authors thank Holly R. Zink, MSA of the Department of Surgery, University of Kansas, Kansas City, KS, for providing medical writing and editorial support for this research.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, University of Kansas Medical Center, 4000 Cambridge Street, Kansas City, KS, 66160, USA

    Amanda Sutherland, Jamie L. Wagner, Sabrina Korentager, Amanda L. Amin, Christa R. Balanoff, Amanda Hangge & Kelsey E. Larson

  2. Department of Plastic Surgery, Medical Center, University of Kansas, Kansas City, KS, USA

    James Butterworth

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  1. Amanda Sutherland
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  2. Jamie L. Wagner
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  3. Sabrina Korentager
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  4. James Butterworth
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  5. Amanda L. Amin
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  6. Christa R. Balanoff
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  7. Amanda Hangge
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  8. Kelsey E. Larson
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Correspondence to Kelsey E. Larson.

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The authors have no financial or non-financial conflicts of interest to report.

Ethical approval

IRB approval was obtained for this study. Ethics approval and consent to participate were not required per IRB.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Sutherland, A., Wagner, J.L., Korentager, S. et al. Is bioimpedance spectroscopy a useful tool for objectively assessing lymphovenous bypass surgical outcomes in breast cancer-related lymphedema?. Breast Cancer Res Treat 186, 1–6 (2021). https://doi.org/10.1007/s10549-020-06059-6

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  • DOI: https://doi.org/10.1007/s10549-020-06059-6

Keywords

  • Breast cancer-related lymphedema
  • Lymphedema
  • Lymphovenous bypass
  • Bioimpedance spectroscopy