The preoperative assessment of
breast cancer patients for subclinical lymphedema enables clinicians to
establish a baseline, which serves to enable the early diagnosis and
successful treatment of the debilitating condition, according to data from
a five-year study published this week in the online edition of the journal
Cancer.


In a study conducted by the National Institutes of Health (NIH) and the
National Naval Medical Center, in collaboration with faculty and students
from the University of Michigan-Flint and George Mason University,
researchers measured the upper limb volume of 196 newly diagnosed breast
cancer patients from 2001 to 2006 to establish a baseline prior to surgery.
At designated postoperative intervals, the researchers took repeated
measurements as part of a "surveillance" model to monitor for possible
impairments related to breast cancer treatment--such as lymphedema--as
opposed to treating therapy-related problems after they occur. Using the
surveillance approach, the investigators demonstrated that a short trial of
compression garments effectively treated subclinical lymphedema when it was
detected early. Forty-three, or 22 percent, of the 196 breast cancer
patients in the study developed subclinical lymphedema, as defined by a
change in limb volume of >75cc; and all subjects showed a significant mean
volume reduction to very near their pre-surgical "normal" state. All
subjects were able to maintain this level for an average of 4.8 months, and
none of the patients demonstrated progression of the condition in the
follow-up period.



Steven Schonholz, M.D., a breast surgeon and medical director of the
Breast Cancer Center at Mercy Medical Center in Springfield, Mass., added:
"The problem with lymphedema is that there hasn't been an easy way to
detect the condition before it is apparent to the doctor and patient. Today
there are new, non-invasive methods that have enabled me to identify the
condition and begin treatment long before the patient is aware of a
problem. If patients aren't treated at the earliest possible indication of
lymphedema, it is less likely to be effectively treated, and the condition
may require life-long costly treatment and, more importantly, have an
enormous impact on a woman's self-esteem, function and quality of life."



While there is no standard tool used to assess the condition,
physicians have relied on tape measures and water displacement to track
changes in limb circumference and size as well as on patients to report
changes in upper extremity mobility. Several diagnostic tools are able to
accurately track minute changes in extracellular fluid to allow for the
earliest possible detection. These include bioimpedance spectroscopy
devices, which use an electrical signal to assess fluid changes in the
body.



"Optimal management of lymphedema requires diagnostic tools that are
sensitive to subclinical changes in tissue," said Dr. Schonholz, who uses
an FDA-cleared low frequency bioimpedance device developed by ImpediMed
Inc. in his practice.



About Lymphedema



Lymphedema is a condition that can cause significant swelling of the
upper and lower extremities due to the build-up of excess lymph fluid. This
can occur when the lymphatic system, which is responsible for draining
excess fluid from the body and is a key component of the immune system, is
damaged or altered. In breast cancer patients, this can occur after
surgery, such as removal or biopsy of the lymph nodes, and/or radiation
therapy. It is estimated that 6 percent to 40 percent of patients with
breast cancer develop lymphedema, and that it often occurs within the first
two years after surgery.



For some cancer survivors and others at risk, a low level lymphedema
can occur 10 years to 15 years following the initial primary treatment and
develop into a condition that has a serious impact on overall health and
quality of life. For more information about lymphedema, visit
http://www.nci.nih.gov/cancerinfo/pdq/supportivecare/lymphedema/patient.


ImpediMed Inc.

http://www.impedimed.com