A Prospective Validation Study of Bioimpedance with Volume Displacement in Early-Stage Breast Cancer Patients at Risk for Lymphedema
Identifieur interne : 002242 ( Main/Exploration ); précédent : 002241; suivant : 002243A Prospective Validation Study of Bioimpedance with Volume Displacement in Early-Stage Breast Cancer Patients at Risk for Lymphedema
Auteurs : Andrea V. Barrio [États-Unis] ; Anne Eaton [États-Unis] ; Thomas G. Frazier [États-Unis]Source :
- Annals of surgical oncology [ 1068-9265 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Association thérapeutique (effets indésirables), Carcinome intracanalaire non infiltrant (), Carcinome intracanalaire non infiltrant (anatomopathologie), Femelle, Humains, Impédance électrique, Invasion tumorale, Lymphoedème (diagnostic), Lymphoedème (étiologie), Pronostic, Spectroscopie diélectrique (), Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Études de suivi, Études prospectives.
- MESH :
- anatomopathologie : Carcinome intracanalaire non infiltrant, Tumeurs du sein.
- diagnostic : Lymphoedème.
- effets indésirables : Association thérapeutique.
- étiologie : Lymphoedème.
- Adulte, Adulte d'âge moyen, Carcinome intracanalaire non infiltrant, Femelle, Humains, Impédance électrique, Invasion tumorale, Pronostic, Spectroscopie diélectrique, Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs du sein, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Breast Neoplasms (complications), Breast Neoplasms (pathology), Breast Neoplasms (therapy), Carcinoma, Intraductal, Noninfiltrating (complications), Carcinoma, Intraductal, Noninfiltrating (pathology), Carcinoma, Intraductal, Noninfiltrating (therapy), Combined Modality Therapy (adverse effects), Dielectric Spectroscopy (methods), Electric Impedance, Female, Follow-Up Studies, Humans, Lymphedema (diagnosis), Lymphedema (etiology), Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Prospective Studies.
- MESH :
- adverse effects : Combined Modality Therapy.
- complications : Breast Neoplasms, Carcinoma, Intraductal, Noninfiltrating.
- diagnosis : Lymphedema.
- etiology : Lymphedema.
- methods : Dielectric Spectroscopy.
- pathology : Breast Neoplasms, Carcinoma, Intraductal, Noninfiltrating.
- therapy : Breast Neoplasms, Carcinoma, Intraductal, Noninfiltrating.
- Adult, Aged, Aged, 80 and over, Electric Impedance, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Prospective Studies.
Abstract
Although volume displacement (VD) is considered the gold standard for diagnosing breast cancer (BC)-related lymphedema, it is inconvenient. We compared bioimpedance (L-Dex) and VD measurements in a prospective cohort of BC patients at risk for lymphedema.
Between 2010–2014, 223 BC patients were enrolled. Following exclusions (n=37), 186 received baseline VD and L-Dex; follow-up measurements were performed at 3–6 month intervals for 3 years. At each visit, patients fit into one of three categories: normal (normal VD and L-Dex); abnormal L-Dex (L-Dex>10 or increase in 10 from baseline and normal VD); or lymphedema (relative arm volume difference of >10% by VD +/− abnormal L-Dex). Change in L-Dex was plotted against change in VD; correlation was assessed using Pearson correlation.
At a median follow-up of 18.2mos, 152 patients were normal; 25 had an abnormal L-Dex; and 9 developed lymphedema without a prior L-Dex abnormality. Of 25 abnormal L-Dex patients, 4 progressed to lymphedema for a total of 13 patients with lymphedema. Evaluating all time points, 186 patients had 829 follow-up measurements. Sensitivity and specificity of L-Dex compared to VD were 75% and 93%, respectively. There was no correlation between change in VD and change in L-Dex at 3mos (R=0.31) or 6mos (R=0.21).
VD and bioimpedance demonstrated poor correlation with inconsistent overlap of measurements considered abnormal. Of patients with an abnormal L-Dex, few progressed to lymphedema; most with lymphedema did not have a prior L-Dex abnormality. Further studies are needed to understand the clinical significance of bioimpedance.
Url:
DOI: 10.1245/s10434-015-4683-0
PubMed: 26085222
PubMed Central: 4684482
Affiliations:
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Barrio</name><affiliation wicri:level="2"><nlm:aff id="A1">Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Surgery, The Bryn Mawr Hospital, Bryn Mawr, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Surgery, The Bryn Mawr Hospital, Bryn Mawr</wicri:cityArea></affiliation></author><author><name sortKey="Eaton, Anne" sort="Eaton, Anne" uniqKey="Eaton A" first="Anne" last="Eaton">Anne Eaton</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York</wicri:cityArea></affiliation></author><author><name sortKey="Frazier, Thomas G" sort="Frazier, Thomas G" uniqKey="Frazier T" first="Thomas G." last="Frazier">Thomas G. Frazier</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Surgery, The Bryn Mawr Hospital, Bryn Mawr, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Surgery, The Bryn Mawr Hospital, Bryn Mawr</wicri:cityArea></affiliation></author></analytic><series><title level="j">Annals of surgical oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Breast Neoplasms (complications)</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (therapy)</term><term>Carcinoma, Intraductal, Noninfiltrating (complications)</term><term>Carcinoma, Intraductal, Noninfiltrating (pathology)</term><term>Carcinoma, Intraductal, Noninfiltrating (therapy)</term><term>Combined Modality Therapy (adverse effects)</term><term>Dielectric Spectroscopy (methods)</term><term>Electric Impedance</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (etiology)</term><term>Middle Aged</term><term>Neoplasm Invasiveness</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Prospective Studies</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Association thérapeutique (effets indésirables)</term><term>Carcinome intracanalaire non infiltrant ()</term><term>Carcinome intracanalaire non infiltrant (anatomopathologie)</term><term>Femelle</term><term>Humains</term><term>Impédance électrique</term><term>Invasion tumorale</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (étiologie)</term><term>Pronostic</term><term>Spectroscopie diélectrique ()</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Combined Modality Therapy</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinome intracanalaire non infiltrant</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term><term>Carcinoma, Intraductal, Noninfiltrating</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Association thérapeutique</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Dielectric Spectroscopy</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term><term>Carcinoma, Intraductal, Noninfiltrating</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term><term>Carcinoma, Intraductal, Noninfiltrating</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Electric Impedance</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Neoplasm Invasiveness</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Carcinome intracanalaire non infiltrant</term><term>Femelle</term><term>Humains</term><term>Impédance électrique</term><term>Invasion tumorale</term><term>Pronostic</term><term>Spectroscopie diélectrique</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs du sein</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>BACKGROUND</title><p id="P1">Although volume displacement (VD) is considered the gold standard for diagnosing breast cancer (BC)-related lymphedema, it is inconvenient. We compared bioimpedance (L-Dex) and VD measurements in a prospective cohort of BC patients at risk for lymphedema.</p></sec><sec id="S2"><title>METHODS</title><p id="P2">Between 2010–2014, 223 BC patients were enrolled. Following exclusions (n=37), 186 received baseline VD and L-Dex; follow-up measurements were performed at 3–6 month intervals for 3 years. At each visit, patients fit into one of three categories: normal (normal VD and L-Dex); abnormal L-Dex (L-Dex>10 or increase in 10 from baseline and normal VD); or lymphedema (relative arm volume difference of >10% by VD +/− abnormal L-Dex). Change in L-Dex was plotted against change in VD; correlation was assessed using Pearson correlation.</p></sec><sec id="S3"><title>RESULTS</title><p id="P3">At a median follow-up of 18.2mos, 152 patients were normal; 25 had an abnormal L-Dex; and 9 developed lymphedema without a prior L-Dex abnormality. Of 25 abnormal L-Dex patients, 4 progressed to lymphedema for a total of 13 patients with lymphedema. Evaluating all time points, 186 patients had 829 follow-up measurements. Sensitivity and specificity of L-Dex compared to VD were 75% and 93%, respectively. There was no correlation between change in VD and change in L-Dex at 3mos (R=0.31) or 6mos (R=0.21).</p></sec><sec id="S4"><title>CONCLUSIONS</title><p id="P4">VD and bioimpedance demonstrated poor correlation with inconsistent overlap of measurements considered abnormal. Of patients with an abnormal L-Dex, few progressed to lymphedema; most with lymphedema did not have a prior L-Dex abnormality. Further studies are needed to understand the clinical significance of bioimpedance.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Barrio, Andrea V" sort="Barrio, Andrea V" uniqKey="Barrio A" first="Andrea V." last="Barrio">Andrea V. Barrio</name></region><name sortKey="Barrio, Andrea V" sort="Barrio, Andrea V" uniqKey="Barrio A" first="Andrea V." last="Barrio">Andrea V. Barrio</name><name sortKey="Eaton, Anne" sort="Eaton, Anne" uniqKey="Eaton A" first="Anne" last="Eaton">Anne Eaton</name><name sortKey="Frazier, Thomas G" sort="Frazier, Thomas G" uniqKey="Frazier T" first="Thomas G." last="Frazier">Thomas G. Frazier</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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