Study the Usefulness of Bio-impedance Spectroscopy in the Early Assessment of Breast Cancer Related Lymphoedema
Study the Usefulness of Bio-impedance Spectroscopy in the Early Assessment of Breast Cancer Related Lymphoedema
The goal of the study is to investigate the use of bio-impedance spectroscopy in the
 assessment of breast cancer related lymphoedema in patients operated with lumpectomy or
 mastectomy, axillary lymph node dissection and radiotherapy compared to inverse water
 volumetry. As a control group, patients with colon rectal cancer are used to compare
 volumetric and spectometric changes during follow-up.
Current assessment of lymphoedema consists of measuring volume changes objectively by a tape
 measure or water displacement. Early recognition of pre-clinical changes of interstitial
 fluid congestion in a limb at risk concerning lymph transport capacity is crucial. Objective
 measurement of extracellular fluids with bio-impedance spectroscopy can detect these early
 signs of lymphoedema. Multi Frequency Bioelectrical Impedance Analysis is completely
 non-invasive, highly reproducible (Ward et al 1997), highly sensitive (Cornish et al 2001),
 highly specific (Cornish et al 2001) and can be repeated as frequently as desired. BIS
 demonstrated excellent inter- and intra-rater reliability. All measures are highly reliably
 in women with and without lymphoedema (Szerniec et al 2010). For women with lymphoedema BIS
 detected a difference in the ECF in limbs which were not reflected in a corresponding
 difference in limb volume. This finding suggests that BIS may be particularly useful in the
 early detection of lymphoedema, before there is any volume change (Szerniez et al 2010). The
 mean ratio of extra cellular water (ECW) to intracellular water (ICW) is 1,5:1 (Ward et al
 2009). Cornish et al (2001) predicted the onset of the condition up to 10 months before the
 condition could be clinically diagnosed. This is considerable shorter than the mean delay
 time of 3,5 years reported by National Summit on Lymphoedema, Adelaide 2000. The only risk
 factor identified as contributing to an increased risk of developing secondary lymphoedema
 was an increasing BMI which is consistent with previous reports (Box et al 2002).

 Early detection with BIS is supposed possible even before clinical signs of swelling are
 available.

 In this study we want to study this hypothesis and as control-group patients treated for
 colorectal carcinoma.
Inclusion Criteria:

 -  Gender: female

 -  Patients operated with lumpectomy or mastectomy, Sentinel node, axillary lymphnode
 dissection and/or chemotherapy and/or radiotherapy.

 -  Controls: operated for colon-rectal carcinoma with colectomy and adjuvant chemotherapy

 -  Patients 18 years or older

 -  No pre-existing clinical or volumetric signs of lymphoedema (CBO guideline: >10%
 difference with contra-lateral side

 Exclusion Criteria:

 -  Allergy against one of the used materials

 -  Patients who have a pacemaker or other inbuilt stimulator

 -  Women who are pregnant

 -  Patients with renal failure or heart failure

 -  Lymphoedema