Teranishi-Hashimoto Cheri, Padilla Monica, Heo Yoomi, Bravi Lori
REHAB Hospital of the Pacific, Honolulu, HI, United States.
InBody BWA, 2550 Eisenhower Avenue, Suite C209, Trooper, PA, 19403, United States, 1 5627415507.
JMIR Form Res. 2025 Jul 24;9:e73978. doi: 10.2196/73978.
Breast cancer, the most common type of diagnosed cancer in women worldwide, is often associated with the development of lymphedema as a treatment-related effect. Patients undergoing surgery, radiation, or chemotherapy present a higher risk for this side effect. Historically, patients are often not referred to rehabilitation for lymphedema management until the swelling is visible and has progressed, which reduces the chance of reversing the disease progression. Surveillance is key to identifying the earliest signs of breast cancer-related lymphedema, initiating treatment, reversing the disease process, and reducing the impact on function.
The primary goal of this study was to assess the feasibility of monitoring fluid levels in patients with cancer using a bioimpedance analysis home device and to detect any relevant changes that may correlate with an increased risk of developing lymphedema. Remote monitoring by a clinician has not previously been possible, and a comparable bioelectrical water analyzer device has never been available to patients within the comfort of their homes.
The study included 8 adult patients diagnosed with unilateral breast cancer who underwent unilateral lumpectomy or mastectomy, bilateral mastectomy, or reconstruction and were followed for 12 months. Patients also underwent radiation or chemotherapy as part of their treatment before the study and, in some cases, during participation in the study. Clinic visits were required every 3 months, with standard care treatment administered by the clinician, as well as daily fluid monitoring, using the extracellular to total body water (ECW/TBW) ratio obtained with the home device.
Preliminary findings from the 8 cases showed that daily monitoring with the home device is possible, and may aid in the detection of fluid changes due to interventions like radiation or chemotherapy; these changes typically subside after treatment, compared to a permanent fluid increase that may indicate lymphedema. While one participant developed lymphedema, there is insufficient data to generalize the feasibility of early detection using the home device. A significant difference between ECW/TBW ratio measurements taken in the morning and evening (P values<.016) was observed for 6 participants, with morning values being higher than evening ones. Additionally, 7 participants showed a higher ECW/TBW ratio in the affected arm compared to the unaffected arm. On average, the ratio between the two values was higher than 1, approximately 75% of the time. The daily monitoring empowered patients to take charge of their health, with more than half expressing a desire to continue using the home device beyond the end of the study period.
This case report shows the feasibility of daily remote monitoring for patients at risk of developing BCRL using a home bioimpedance analysis device.
乳腺癌是全球女性中最常见的确诊癌症类型，常与作为治疗相关效应的淋巴水肿的发生有关。接受手术、放疗或化疗的患者出现这种副作用的风险更高。从历史上看，患者通常直到肿胀可见且病情进展时才被转介至康复机构进行淋巴水肿管理，这降低了逆转疾病进展的机会。监测是识别乳腺癌相关淋巴水肿最早迹象、启动治疗、逆转疾病进程以及减少对功能影响的关键。
本研究的主要目标是评估使用生物电阻抗分析家用设备监测癌症患者体液水平的可行性，并检测任何可能与发生淋巴水肿风险增加相关的相关变化。此前临床医生无法进行远程监测，且患者在家中舒适环境下也从未有过类似的生物电水分分析仪设备。
该研究纳入了8名诊断为单侧乳腺癌的成年患者，这些患者接受了单侧乳房肿瘤切除术或乳房切除术、双侧乳房切除术或乳房重建，并随访12个月。患者在研究前以及在某些情况下在参与研究期间还接受了放疗或化疗作为其治疗的一部分。每3个月需要进行一次门诊就诊，由临床医生进行标准护理治疗，以及使用家用设备获得的细胞外液与总体液（ECW/TBW）比值进行每日体液监测。
8例患者的初步研究结果表明，使用家用设备进行每日监测是可行的，并且可能有助于检测因放疗或化疗等干预导致的体液变化；与可能表明淋巴水肿的永久性体液增加相比，这些变化通常在治疗后消退。虽然有一名参与者发生了淋巴水肿，但尚无足够数据来概括使用家用设备进行早期检测的可行性。6名参与者的早晨和晚上测量的ECW/TBW比值存在显著差异（P值<0.016），早晨的值高于晚上的值。此外，7名参与者受影响手臂的ECW/TBW比值高于未受影响的手臂。平均而言，这两个值之间的比值在大约75%的时间里高于1。每日监测使患者能够掌控自己的健康，超过一半的患者表示希望在研究期结束后继续使用家用设备。
本病例报告显示了使用家用生物电阻抗分析设备对有发生乳腺癌相关淋巴水肿风险的患者进行每日远程监测的可行性。
