Breast cancer-related lymphedema can significantly compromise quality of life. Bioimpedance
spectroscopy (BIS) measures extracellular fluid in lymphedema. The purpose of this
study was to determine the incidence of BIS-detected lymphedema using the L-Dex and
identify risk factors associated with a positive score.
Materials and Methods
We performed a retrospective review of our institutional database to identify patients
who underwent L-Dex U400 measurements. Patients with a score of > 10 L-Dex units or
with an increase of > 10 units from baseline had a positive score. Clinical lymphedema
was determined by documentation in the chart at the time of positive measurement.
Otherwise, patients were considered to have subclinical lymphedema.
Fifty-three patients met study criteria. Thirty patients (56.6%) underwent mastectomy,
22 (41.5%) axillary lymph node dissection (ALND), and 33 (62.3%) received radiation
(RT). Twelve patients (22.6%) had a positive score. There were no differences in age,
race, laterality, breast surgery, T stage, N stage, chemotherapy, or RT fields (none,
breast only, breast with LNs) in patients with a positive score. ALND was more common
(66.7% vs. 34.2%, P= .04). BMI > 30 approached significance (58.3% vs. 29.3%, P= .06). Seven patients had subclinical lymphedema. No differences were identified
comparing patients with subclinical lymphedema to those with negative scores. All
5 patients with clinical lymphedema underwent ALND and received nodal RT.
The combination of ALND and regional nodal RT is strongly associated with development
of clinical lymphedema. It is difficult to identify patients at risk for subclinical