Lymphedema Clinical Trial
Official title:
Prospective Controlled Study Comparing the Effectiveness and Specificity of Inverse Water Volumetry Versus Bio-impedance Spectroscopy in the Assessment of Early Recognition of Breast Cancer Related Lymphoedema.
The goal of the study is to investigate the use of bio-impedance spectroscopy in the assessment of breast cancer related lymphoedema in patients operated with lumpectomy or mastectomy, axillary lymph node dissection and radiotherapy compared to inverse water volumetry. As a control group, patients with colon rectal cancer are used to compare volumetric and spectometric changes during follow-up.
Current assessment of lymphoedema consists of measuring volume changes objectively by a tape
measure or water displacement. Early recognition of pre-clinical changes of interstitial
fluid congestion in a limb at risk concerning lymph transport capacity is crucial. Objective
measurement of extracellular fluids with bio-impedance spectroscopy can detect these early
signs of lymphoedema. Multi Frequency Bioelectrical Impedance Analysis is completely
non-invasive, highly reproducible (Ward et al 1997), highly sensitive (Cornish et al 2001),
highly specific (Cornish et al 2001) and can be repeated as frequently as desired. BIS
demonstrated excellent inter- and intra-rater reliability. All measures are highly reliably
in women with and without lymphoedema (Szerniec et al 2010). For women with lymphoedema BIS
detected a difference in the ECF in limbs which were not reflected in a corresponding
difference in limb volume. This finding suggests that BIS may be particularly useful in the
early detection of lymphoedema, before there is any volume change (Szerniez et al 2010). The
mean ratio of extra cellular water (ECW) to intracellular water (ICW) is 1,5:1 (Ward et al
2009). Cornish et al (2001) predicted the onset of the condition up to 10 months before the
condition could be clinically diagnosed. This is considerable shorter than the mean delay
time of 3,5 years reported by National Summit on Lymphoedema, Adelaide 2000. The only risk
factor identified as contributing to an increased risk of developing secondary lymphoedema
was an increasing BMI which is consistent with previous reports (Box et al 2002).
Early detection with BIS is supposed possible even before clinical signs of swelling are
available.
In this study we want to study this hypothesis and as control-group patients treated for
colorectal carcinoma.
;
Time Perspective: Prospective
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