Okamichi Aya, Watanabe Miyoko, Kurosawa Kazuo
Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare: 4-3 Kozunomori, Narita-shi, Chiba 286-8686, Japan.
Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, Japan.
J Phys Ther Sci. 2024 Oct;36(10):672-676. doi: 10.1589/jpts.36.672. Epub 2024 Oct 1.
[Purpose] To characterize changes in the body composition of individuals with secondary lymphedema that developed in the early postoperative period after breast cancer surgery, before the manifestation of volume increase in the affected limb, and to test its potential as a screening indicator for preventive intervention. [Participants and Methods] A total of 219 patients with breast cancer who underwent axillary lymph node dissection and sentinel lymph node biopsy were included in this study. Body composition (extracellular water content, extracellular water content ratio, low-frequency impedance value, and phase angle) was evaluated using bioelectrical impedance analysis before surgery and three and six months after surgery. Changes in the body composition of the affected limb over time were compared between the lymphedema- and non-lymphedema-affected groups. [Results] Sixteen patients who developed lymphedema six months after breast cancer treatment showed significant changes in all body composition parameters at three months postoperatively, compared to those who did not develop lymphedema. [Conclusion] In patients with upper extremity lymphedema that develops within six months after breast cancer surgery, increases in extracellular water content, extracellular water content ratio, low-frequency impedance, and phase angle may precede apparent volume increases. Our findings suggest the usefulness of these parameters as screening indicators for early treatment triaging.
[目的] 描述乳腺癌手术后早期发生继发性淋巴水肿、患侧肢体尚未出现体积增加时个体身体成分的变化,并测试其作为预防性干预筛查指标的潜力。[参与者与方法] 本研究纳入了219例行腋窝淋巴结清扫和前哨淋巴结活检的乳腺癌患者。在手术前以及术后3个月和6个月,使用生物电阻抗分析评估身体成分(细胞外含水量、细胞外含水量比率、低频阻抗值和相位角)。比较淋巴水肿组和非淋巴水肿组患侧肢体身体成分随时间的变化。[结果] 与未发生淋巴水肿的患者相比,乳腺癌治疗6个月后发生淋巴水肿的16例患者在术后3个月时所有身体成分参数均出现显著变化。[结论] 在乳腺癌手术后6个月内发生上肢淋巴水肿的患者中,细胞外含水量、细胞外含水量比率、低频阻抗和相位角的增加可能先于明显的体积增加。我们的研究结果表明这些参数作为早期治疗分类筛查指标的有用性。