Ridner Sheila H, Dietrich Mary S, Spotanski Kandace, Doersam Jennifer K, Cowher Michael S, Taback Bret, McLaughlin Sarah, Ajkay Nicolas, Boyages John, Koelmeyer Louise, DeSnyder Sarah, Shah Chirag, Vicini Frank
1 School of Nursing, Vanderbilt University , Nashville, Tennessee.
2 Department of Biostatistics, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee.
Lymphat Res Biol. 2018 Oct;16(5):435-441. doi: 10.1089/lrb.2017.0070. Epub 2018 Aug 21.
Data regarding pretreatment, bioimpedance spectroscopy (BIS) L-Dex values for patients newly diagnosed with breast cancer, and longitudinal data 12 months postoperatively are lacking. This study describes L-Dex values at the time of breast cancer diagnosis and maximum L-Dex change within 12 months of surgery.
Patients were enrolled in a parent, clinical trial that compares the effectiveness of BIS for early detection of breast cancer-related lymphedema to tape measurement. A total of 280 women with a pretreatment and at least one postoperative L-Dex measurement (within 12 months of surgery) were included. Pretreatment L-Dex readings were compared with population norms and maximum L-Dex changes within 12 months were examined. An L-Dex U400 device was used to obtain BIS measurements. The documented normative mean value using this device is 0.00, which is at the 49th percentile for this sample. Approximately 6% of patients had a pretreatment L-Dex value of ≥7.0; 1.8% had an L-Dex value ≥10.0. For 12 months, 17.1% (n = 48) of patients had a maximum change in L-Dex value from pretreatment of ≥7.0 L-Dex units, suggestive of clinical lymphedema.
At the time of breast cancer diagnosis, L-Dex values are similar to normative values. Identified maximum changes in L-Dex values 12 months postoperatively suggest that frequent L-Dex measurements during that time frame are of potential clinical benefit. Our findings are consistent with research supporting an L-Dex value of ≥7 as indicative of clinical lymphedema with subclinical lymphedema logically occurring at somewhat lower likely, near ≥6.5.
缺乏关于新诊断乳腺癌患者的预处理生物电阻抗光谱(BIS)L-Dex值以及术后12个月纵向数据的相关资料。本研究描述了乳腺癌诊断时的L-Dex值以及手术12个月内L-Dex的最大变化。
患者参与了一项母体临床试验,该试验比较了BIS与卷尺测量法在早期检测乳腺癌相关淋巴水肿方面的有效性。总共纳入了280名有预处理及至少一次术后L-Dex测量值(手术12个月内)的女性。将预处理L-Dex读数与总体标准值进行比较,并检查手术12个月内L-Dex的最大变化。使用L-Dex U400设备获取BIS测量值。使用该设备记录的标准平均值为0.00,在本样本中处于第49百分位数。约6%的患者预处理L-Dex值≥7.0;1.8%的患者L-Dex值≥10.0。在12个月内,17.1%(n = 48)的患者L-Dex值相对于预处理的最大变化≥7.0 L-Dex单位,提示临床淋巴水肿。
在乳腺癌诊断时,L-Dex值与标准值相似。术后12个月L-Dex值的最大变化表明,在此时间段内频繁进行L-Dex测量具有潜在的临床益处。我们的研究结果与支持L-Dex值≥7表示临床淋巴水肿的研究一致,亚临床淋巴水肿可能在略低水平(接近≥6.5)时出现。