A Prospective Study of L-Dex Values in Breast Cancer Patients Pretreatment and Through 12 Months Postoperatively
Sheila H. Ridner, PhD, RN, FAAN, 1 Mary S. Dietrich, PhD,1,2 Kandace Spotanski, MMHC, 1 Jennifer K. Doersam, MS, 1 Michael S. Cowher, MD, 3 Bret Taback, MD, 4 Sarah McLaughlin, MD, 5 Nicolas Ajkay, MD, 6 John Boyages, MD, PhD, 7 Louise Koelmeyer, BAppSc(OT), 7 Sarah DeSnyder, MD, 8 Chirag Shah, MD, 9 and Frank Vicini, MD10. LYMPHATIC RESEARCH AND BIOLOGY 2018
Background: Data regarding pretreatment, bioimpedance spectroscopy (BIS) L-Dexvalues for patients newly diagnosed with breast cancer, and longitudinal data 12 months postoperatively are lacking. This study describes L-Dex values at the time of breast cancer diagnosis and maximum L-Dex change within 12 months of surgery.
Methods and Results: Patients were enrolled in a parent, clinical trial that compares the effectiveness of BIS for early detection of breast cancer-related lymphedema to tape measurement. A total of 280 women with a pretreatment and at least one post operativeL-Dex measurement (within 12 months of surgery) were included. Pretreatment L-Dex readings were compared with population norms and maximum L-Dex changes within 12 months were examined. An L-Dex U400 device was used to obtain BIS measurements. The documented normative me an value using this device is 0.00, which is at the 49th percentile for this sample. Approximately 6% of patients had a pretreatment L-Dex value of‡7.0; 1.8% had an L-Dex value ‡10.0. For 12 months, 17.1% (n=48) of patients had a maximum change in L-Dex value from pretreatment of ‡7.0L-Dex units, suggestive of clinical lymphedema.
Conclusions: At the time of breast cancer diagnosis, L-Dex values are similar to normative values. Identiﬁed maximum changes in L-Dex values 12 months postoperatively suggest that frequent L-Dex measurements during that time frame are of potential clinical beneﬁt. Our ﬁndings are consistent with research supporting an L-Dex value of ‡7 as indicative of clinical lymphedema with subclinical lymphedema logically occurring at somewhat lower likely, near ‡6.5.