A study conducted by researchers at The University of Kansas Cancer Center has found that early, ongoing screening of lymphatic function and immediate patient-administered therapies are highly effective in improving outcomes for women at high risk for breast cancer related lymphedema.
Lymphedema is a condition that can happen when breast cancer surgery includes removal of lymph nodes, or through other breast cancer treatment like radiation or chemotherapy. It is often diagnosed in later stages, when the condition cannot be reversed. Lymphedema's chronic swelling may lead to pain, decreased arm range of motion and potentially infection, significantly lowering a woman's quality of life. Rates of breast cancer-related lymphedema in high-risk patients range from 20 to 40 percent.
Using bioimpedance spectroscopy (BIS) to measure extracellular fluid, the study found that 82 percent of women identified at an early stage of lymphatic impairment returned to their normal pre-treatment measurements following therapy. The conservative home treatment program combines compression sleeve garments and self-directed massage.
"This study shows that early intervention is crucial in addressing lymphatic changes before they reach clinically apparent levels that are likely to become permanent," says Lyndsey Kilgore, MD, researcher at The University of Kansas Cancer Center.
Dr. Kilgore, who led the study with the help of her mentor Jamie Wagner, DO, explains that BIS technology uses electrical currents to assess the body fluid volume and is highly effective in identifying lymphedema at early stages prior to the onset of clinical symptoms.
"Identifying the appropriate patients at the appropriate time is imperative. After the disease has progressed, more complex, costly interventions are necessary with less potential for resolving to the baseline measurements."
In the study, nearly 150 participants considered at high risk for lymphedema had baseline BIS readings taken before surgery or systemic therapy, as well as periodic measurements for at least one year after surgery.
All patients who developed subclinical or stage I lymphedema had resolution of their lymphedema after initiation of treatment, which included compression sleeve garments and self-massage. Overall, only 6 percent of patients in the study developed clinically persistent lymphedema. Historically, lymphedema rates for similarly treated patients range from 20 to 40 percent.
"Bioimpedance spectroscopy (BIS) is a highly effective, fast and non-invasive objective tool in monitoring lymph fluid retention," said Dr. Kilgore. "We hope this study will help usher in a new protocol involving precise, highly controlled monitoring and immediate intervention to reverse early lymphatic changes prior to damage that leads to chronic, irreversible lymphedema."
The University of Kansas Cancer Center is the only facility in the area, and one of a few in the country, with a comprehensive lymphedema program focused not only on lymphedema treatment, but also on surveillance and prevention. Every breast cancer patient sees a lymphedema clinician for education, measurements and prospective monitoring.