title: Experimental and Analytical Comparisons of Tissue Dielectric Constant (TDC) and Bioimpedance Spectroscopy (BIS) in Assessment of Early Arm Lymphedema in Breast Cancer Patients after Axillary Surgery and Radiotherapy.
abstract: BACKGROUND
  Early diagnosis of breast cancer treatment-related lymphedema (BCRL) is of great importance for longstanding treatment results. Tissue dielectric constant (TDC) and bioimpedance spectroscopy (BIS) both have a potential for early diagnosis, but have not been compared.
  
  
  RESULTS
  One hundred women, treated for breast cancer with breast surgery, axillary dissection, and radiotherapy, were examined within one year after breast cancer treatment, as part of the follow-up procedure. Affected/at-risk and contralateral arms were measured with the TDC technique specific to localized skin water content and the BIS technique assessing arm extracellular fluid (ECF). Thirty-eight patients were clinically diagnosed for lymphedema (38.0%). The sensitivity and specificity for the TDC method were 65.8% and 83.9%, and for BIS method 42.1% and 93.5%, (p < 0.001 and NS), respectively. Of all lymphedema, 18.4% were detected only by TDC and 2.6% by BIS. Affected arm to contralateral arm TDC ratios for upper arm and forearm, 1.56 ± 0.49 and 1.28 ± 0.33, demonstrating the localized feature of the TDC measurements were significantly greater than the BIS arm ratio 1.12 ± 0.12 (both p < 0.001).
  
  
  CONCLUSIONS
  Discrepancies between TDC and BIS techniques in assessing lymphedema are related to different measurement techniques and assessed tissue water components. Independently of selected technique-specific threshold limit, the TDC technique was more sensitive than the BIS technique in the early assessment of BCRL and demonstrated that nearly 20% of early lymphedema are only superficially localized. The results further supported the complementary role of TDC and arm volume measurements as a highly diagnostic method for early lymphedema.
authors: 1 Cancer Center, Kuopio University Hospital , Kuopio, Finland .
authors: Tapani
authors: T
authors: Lahtinen
authors: 1 Cancer Center, Kuopio University Hospital , Kuopio, Finland .
authors: Jan
authors: J
authors: Seppälä
authors: 1 Cancer Center, Kuopio University Hospital , Kuopio, Finland .
authors: Tuomas
authors: T
authors: Viren
authors: 2 Department of Health Sciences, Lund University , Lund, Sweden .
authors: Karin
authors: K
authors: Johansson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000473:pathology*; D001365:Axilla; D001943:Breast Neoplasms / Q000150:complications* / Q000532:radiotherapy / Q000601:surgery; D058266:Dielectric Spectroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology*; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009929:Organ Size