Bioimpedance and upper limb lymphedema index in the diagnosis of lymphedema in post-mastectomy syndrome

Methods for assessing post-mastectomy edema: bioimpedance and upper extremity lymphedema index (UEL index) are non-invasive, highly sensitive and easily feasible diagnostic methods, suitable for predicting the prospects of surgical treatment and analyzing the dynamics of edema. The purpose of the study was to study UEL index indicators and bioimpedance data at different stages of upper extremity lymphedema. Material and methods. The study included 64 patients with post-mastectomy edema who underwent bioimpedance, measurement of the circumference of the upper extremity and calculation of the UEL index. Results. The upper extremity lymphedema index and bioimpedance parameters (fluid volume in the limb and the ratio of extracellular fluid to total fluid volume) characterizing the liquid component significantly increased at stages II and III of lymphedema in comparison with the control group. a statistically significant correlation was revealed between the upper limb lymphedema index and bioimpedance parameters (R=0.41) and (R=0.49), respectively. Conclusion. Bioimpedance parameters and values of the upper extremity lymphedema index can be interchangeable. The reliability and high sensitivity of these methods for assessing post-mastectomy edema allows us to obtain quantitative criteria for evaluating the liquid component at different stages of lymphedema.

1. Feoldi M., Casley-Smith J.R. Lymphangiology. New York: Stuttgart, 1983. 832 p.

2. Yamamoto T., Yamamoto N., Hara H., Mihara M., Narushima M., Koshima I. Upper extremity lymphedema index: a simple method for severity evaluation of upper extremity lymphedema. Ann Plast Surg. 2013;70(1): 47–9. doi: 10.1097/SAP.0b013e3182275d23.

3. Campisi C., Boccardo F. Microsurgical techniques for lymphedema treatment: derivative lymphatic-venous microsurgery. World J Surg. 2004; 28(6): 609–13. doi: 10.1007/s00268-004-7252-4.

4. Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020; 53(1): 3–19.

5. American Physical Therapy Association. Guide to Physical Therapist Practice. Second Edition. American Physical Therapy Association. Phys Ther. 2001; 81(1): 9–746.

6. Neligan P.C., Masia J., Piller N.B. Lymphedema: Complete Medical and Surgical Management. 1st Edition. Thieme Medical Publishers. 2016. 657 p. doi: 10.1055/b-004-140253.

7. Toshima M., Morino Y. Water Distribution Changes in Complex Decongestive Treatment for Leg Lymphedema: Quantitative Evaluation by Direct Segmental Multi-Frequency Bioimpedance Analysis. Ann Vasc Dis. 2022; 15(2): 94–100. doi: 10.3400/avd.oa.22-00037.

8. Shah C., Whitworth P., Valente S., Schwarz G.S., Kruse M., Kohli M., Brownson K., Lawson L., Dupree B., Vicini F.A. Bioimpedance spectroscopy for breast cancer-related lymphedema assessment: clinical practice guidelines. Breast Cancer Res Treat. 2023; 198(1): 1–9. doi: 10.1007/s10549-022-06850-7.

9. Mayrovitz H.N. Noninvasive Measurements of Breast Cancer-Related Lymphedema. Cureus. 2021; 13(11): 1–8. doi: 10.7759/cureus.19813.

10. Kim W.J., Jo G.Y., Park J.H., Do H.W. Feasibility of segmental bioelectrical impedance analysis for mild- to moderate-degree breast cancer-related lymphedema. Medicine (Baltimore). 2021; 100(4): 1–8. doi: 10.1097/MD.0000000000023722.

11. Warren A.G., Janz B.A., Slavin S.A., Borud L.J. The use of bioimpedance analysis to evaluate lymphedema. Ann Plast Surg. 2007; 58(5):541–3. doi: 10.1097/01.sap.0000244977.84130.cf.