Improving the Assessment and Diagnosis of Breast Lymphedema after Treatment for Breast Cancer

Riches, Katie; Cheung, Kwok Leung; Keeley, Vaughan

Abstract

Lymphedema can develop after treatment for breast cancer (BCRL). Lymphedema of the breast is not well studied. Currently, the main techniques used to diagnose and monitor the effectiveness of treatment are subjective clinician assessment and patient reports. Eighty-nine women who had undergone breast cancer treatment were recruited with and without breast lymphedema. Blinded clinical assessment determined the presence or absence of breast lymphedema. Measurement of skin thickness by ultrasound scanning, local tissue water by tissue dielectric constant (TDC) and tissue indentation by tonometry was recorded. Breast cancer treatment and demographic details were documented. Descriptive statistics were undertaken to compare sample characteristics, including the Chi-squared test, Odds Ratio (OR) and Relative Risks (RR) calculated. Increased body mass index (BMI), larger bra size, increased number of positive lymph nodes, axillary surgery, chemotherapy and increased Nottingham Prognostic Index (NPI) were all associated with breast lymphedema (p < 0.05). Ultrasound and TDC measurements were significantly higher in the lymphedema group (p < 0.05). Receiver Operator Characteristic (ROC) curves demonstrated that ultrasound and TDC measurements could distinguish between edematous and non-edematous breasts. Threshold levels were produced, which demonstrated good levels of sensitivity and specificity. These findings have the potential to improve the diagnosis of breast lymphedema.

Citation

Riches, K., Cheung, K. L., & Keeley, V. (2023). Improving the Assessment and Diagnosis of Breast Lymphedema after Treatment for Breast Cancer. Cancers, 15(6), Article 1758. https://doi.org/10.3390/cancers15061758

• Journal Article Type: Article
• Acceptance Date: Mar 8, 2023
• Online Publication Date: Mar 14, 2023
• Publication Date: Mar 14, 2023
• Deposit Date: Mar 31, 2023
• Publicly Available Date: Mar 31, 2023
• Journal: Cancers
• Electronic ISSN: 2072-6694
• Publisher: MDPI AG
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 6
• Article Number: 1758
• DOI: https://doi.org/10.3390/cancers15061758
• Keywords: Breast cancer; breast lymphedema; assessment; ultrasound; tissue dielectric constant; tonometry
• Public URL: https://nottingham-repository.worktribe.com/output/18529765
• Publisher URL: https://www.mdpi.com/2072-6694/15/6/1758
• Additional Information: Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland.; This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)