A team of researchers led by Mei R. Fu, PhD, RN, ACNS-BC, associate professor of Chronic Disease Management at the New York University College of Nursing (NYUCN), offers supporting evidence for using Bioelectrical Impedance Analysis (BIA) ratios to assess Lymphedema. The study, “L-DEX Ratio in Detecting Breast Cancer-Related Lymphedema: Reliability, Sensitivity, and Specificity,” published in Lymphology, argues because the low frequency electronic current cannot travel through cell membranes, it provides a direct measure of lymph fluid outside the cells. This allows for a more accurate assessment of lymphedema using a Lymphedema Index named L-Dex ratio.
“To lessen breast cancer survivors’ worry about lymphedema development, the BIA may have a role in clinical practice by adding confidence in the detection of arm lymphedema among breast cancer survivors,” says Dr. Fu, “even when pre-surgical BIA baseline measures are not available.”
The objective of the study was to examine the reliability, sensitivity, and specificity of cross-sectional assessment of BIA in detecting lymphedema in a large metropolitan clinical setting.
Measuring lymphedema is challenging because most methods cannot distinguish bone and soft tissues from extracellular fluid. BIA is time-efficient, easy to operate and easy to interpret, making it ideal for clinical practice. Dr. Fu’s research collected data from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema, demonstrating that survivors with lymphedema had significantly higher L-Dex ratios, which shows the possibility of using BIA to discriminate between those cohorts of women.
“Our study also demonstrated that using a more sensitive L-Dex cutoff point, this allowed for BIA to catch 34% of the usually missed lymphedema cases,” said Dr. Fu. “This allows for earlier treatment, which naturally leads to better outcomes for at-risk patients.”
While not ready for practical use, this technique offers a new (and potentially better) approach to assessing patients for arm swelling related to breast cancer management. Fortunately, we are seeing the risk of serious lymphedema diminish with more innovative management approaches such as the sentinel lymph node biopsy. I’m Dr. Michael Hunter.
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Reference: New York University (2013, November 12). New solution in detecting breast-cancer related lymphedema. ScienceDaily. Retrieved November 13, 2013, from http://www.sciencedaily.com/releases/2013/11/131112162804.htm