MAY 24, 2019

Technology better than tape measure for identifying lymphedema risk

WRITTEN BY: Nouran Amin

A multisite international study proved that technology is now better than tape to measure the risk of a female developing lymphedema after breast cancer surgery. The technology is Bioimpedance spectroscopy (BIS)--a painless and noninvasive procedure that depends on running electronic signals through the body that is similar to electronic monitors for measuring body mass index. BIS is used for assessment purposes and was found to reduce rates of progression by approximately 10%.

Learn more about bioimpedance spectroscopy technology:

"The bioimpedance device measures lymphatic fluid, and the tape measures everything," said Sheila Ridner, PhD, RN, Martha Ingram Professor and director of the PhD in Nursing Science Program at Vanderbilt University School of Nursing. "It takes more lymphatic fluid to make your whole arm volume change than it does to make the device pick up changes. The device is just more sensitive to changes in lymphatic fluid."

The study compared two methods for identifying women who should receive compression sleeves and gauntlets to decrease lymphatic fluid in the arm and prevent progression to lymphedema. Breast cancer related lymphedema affects between 20% and 30% percent of women from damage to their lymphatic glands from surgery, radiation and some medicines. Lymphedema leads to swelling in the arm, can cause physically debilitation and places women at greater risk for infections along with psychological stress.

"Lymphedema therapists are not accessible everywhere and mostly are in metropolitan areas. You go an hour-and-a-half in any direction outside of Nashville, for example, and we can't find people to treat these patients."

Learn more about lymphedema:

https://www.youtube.com/watch?v=Dp04BbINLiY

"Tape measure is the most commonly used method around the world even though it is fraught with error," Ridner said. "To get accurate measurements for a research study, there is an incredible amount of training to teach all the sites in this international study how to measure the same way. I do annual fidelity oversight visits to every single site to make sure there has not been any slippage in the protocol."

Findings of the study were published in Annals of Surgical Oncology.

"We had statistically significant more people trigger an intervention that were in the tape group than in the BIS group, which was contrary to what many people thought would have happened in the study. One of the concerns about BIS in general was that it might generate false positives and we might psychologically distress people," Ridner said. "That was never my experience in the 15 to 16 years I've been working with the technology."

Source: Vanderbilt University