Division of Breast Surgery, Department of Surgery, University of Kansas Medical Center, 4000 Cambridge Street, Kansas City, KS, 66160, USA.
Department of Plastic Surgery, Medical Center, University of Kansas, Kansas City, KS, USA.
Breast Cancer Res Treat. 2021 Feb;186(1):1-6. doi: 10.1007/s10549-020-06059-6. Epub 2021 Jan 4.
We sought to determine if bioimpedance spectroscopy (BIS) measurements can accurately assess changes in breast cancer-related lymphedema (BCRL) in patients undergoing lymphovenous bypass (LVB).
Patients undergoing LVB for BCRL refractory to conservative treatment from 1/2015 to 12/2018 were identified from an IRB-approved prospectively maintained database at a single institution. All breast cancer patients were assessed with baseline BIS measurements prior to any oncologic surgery and serial BIS during follow-up office visits including before and after LVB. Clinicopathologic information, LVB operative details, and pre- and post-LVB operative BIS measurements were collected. Analysis focused on clinically significant BIS change, defined as two standard deviations (SD), and comparing LVB anastomosis to BIS changes.
During the study timeframe, nine patients underwent LVB for treatment of BCRL. The majority (78%) received radiation, taxane chemotherapy, and underwent axillary dissection. An average of 5.6 LVB anastomoses were performed per patient. The average change in BIS following LVB was a 3SD reduction, indicating a clinically significant change. This improvement was stable over time, with persistent 2SD reduction at 22 months postoperatively. The number of LVB anastomoses performed did not significantly correlate with the degree of BIS change.
This is the first study to utilize BIS measurements to assess response to LVB surgical intervention for BCRL. BIS measurements demonstrated clinically significant improvement after LVB, providing objective evidence in support of this surgical treatment for BCRL. BIS changes should be reported as key objective data in future studies assessing BCRL interventions, including response to LVB.
我们旨在确定生物阻抗谱（BIS）测量是否可以准确评估接受淋巴静脉旁路（LVB）治疗的乳腺癌相关淋巴水肿（BCRL）患者的变化。
从一家机构的 IRB 批准的前瞻性维护数据库中确定了自 2015 年 1 月至 2018 年 12 月期间因保守治疗无效而接受 LVB 治疗的 BCRL 患者。所有乳腺癌患者均在任何肿瘤手术前进行基线 BIS 测量，并在包括 LVB 前后的随访门诊期间进行系列 BIS 测量。收集临床病理信息、LVB 手术细节以及 LVB 前后的 BIS 测量值。分析重点是临床显著的 BIS 变化，定义为两个标准差（SD），并比较 LVB 吻合术与 BIS 变化。
在研究期间，九名患者因 BCRL 接受 LVB 治疗。大多数（78％）接受了放疗、紫杉烷化疗，并进行了腋窝清扫。平均每位患者进行了 5.6 个 LVB 吻合术。LVB 后 BIS 的平均变化为 3SD 降低，表明存在临床显著变化。这种改善是稳定的，术后 22 个月持续降低 2SD。进行的 LVB 吻合术数量与 BIS 变化的程度没有显著相关性。
这是第一项利用 BIS 测量来评估 LVB 手术干预对 BCRL 反应的研究。LVB 后 BIS 测量显示出明显的临床改善，为这种治疗 BCRL 的手术治疗提供了客观证据。BIS 变化应作为评估 BCRL 干预措施（包括对 LVB 的反应）的未来研究中的关键客观数据进行报告。
