The effect of adjuvant radiotherapy on skin biophysical properties in patients with breast cancer at risk for breast lymphedema: A prospective study

Risk Profiling of Breast Cancer-Related Lymphedema (BCRL) in Patients With Breast Cancer Via Using Body Composition and Tissue Dielectric Constant (TDC) Method: A Cross-Sectional Study

BACKGROUND

Breast Cancer-Related Lymphedema (BCRL) is one of the most prominent long-term side effects of breast cancer (BC) treatment. Although an increased BMI is a well-recognized risk factor for BCRL, there is a lack of knowledge regarding the potential associations between body composition and the risk of BCRL. Therefore, this study aimed to analyze the BCRL risk profiles of surgically operated BC patients via body composition and the Tissue Dielectric Constant (TDC) method, respectively.

METHODS

A total of 72 patients were included. Patients' risk for BCRL was assessed with Moisture MeterD (Delfin, Finland) in 4 different probes each has unique penetration depths from 0.5 (10 mm) to 5.0 (55 mm) at both upper extremities. The body composition was analyzed with Tanita-BC-420 (TANITA, Japan). Comparing the dielectric values of extremities and proportioning to one another as TDC ratio (at-risk side/unaffected side) was used to profile BCRL risk.

RESULTS

TDC values of the thorax reference point were significantly higher in all four probes on the at-risk side (P < .05). TDC ratios in the forearm and Thorax points were significantly correlated with fat mass (r = 0.256, P = .030; r = 0.269, P = .022) as well as with visceral fat rating (VFR) (r = 0.340, P = .003; r = 0.466, P < .001).

CONCLUSION

This study highlights the need for further care and investigation in the assessment and prediction of BCRL by considering body composition. Since the risk reduction of BCRL can be maximized by considering the individual features, we can conclude that patients with higher body fat irrespective of the BMI should be followed up regularly.

Breast lymphedema following breast-conserving treatment for breast cancer: current status and future directions

PURPOSE

To examine the current evidence on breast lymphedema (BL) diagnosis and treatment after breast-conserving surgery, identify gaps in the literature, and propose future research directions.

METHODS

A comprehensive literature review was conducted using Ovid, PubMed, and Cochrane, including studies published between 2000 and 2023. References were reviewed manually for eligible studies. Inclusion criteria were as follows: patients who underwent breast conserving treatment (surgery ± radiation) for breast cancer, goals of the paper included analyzing or reviewing BL measurement with ultrasound or tissue dielectric constant, or BL treatment. Twenty-seven manuscripts were included in the review.

RESULTS

There is variation in incidence, time course, and risk factors for BL. Risk factors for BL included breast size, primary and axillary surgery extent, radiation, and chemotherapy but require further investigation. Diagnostic methods for BL currently rely on patient report and lack standardized criteria. Tissue dielectric constant (TDC) and ultrasound (US) emerged as promising ambulatory BL assessment tools; however, diagnostic thresholds and validation studies with ICG lymphography are needed to establish clinical utility. The evidence base for treatment of BL is weak, lacking high-quality studies.

CONCLUSION

The natural history of BL is not well defined. TDC and US show promise as ambulatory assessment tools for BL; however, further validation with lymphatic imaging is required. BL treatment is not established in the literature. Longitudinal, prospective studies including pre-radiation measurements and validating with lymphatic imaging are required. These data will inform screening, diagnostic criteria, and evidence-based treatment parameters for patients with BL after breast-conserving surgery and radiation.

Medical Applications of Skin Tissue Dielectric Constant Measurements

Tissue dielectric constant (TDC) values assess certain skin properties that are dependent on multiple factors but mainly on the relative amount of water content within a locally measured tissue volume. Because of the non-invasive nature of these measurements and their ease of use, the method has been widely used in various medically related applications. The goal of this paper was to review and describe the uses and findings of such TDC measurements, considering and including the wide array of medical applications. The review is in part based on information derived from an analysis of published material obtained via literature searches of four major electronic databases and, in part, based on the author's experience with the TDC measurement methods and their various applications and his professional experiences. The databases searched were PubMed, Web of Science, EMBASE, and CINAHL Complete. Based on the initial search criteria, a total of 1257 titles were identified. After removing duplicates and filtering according to relevancy, 160 remained for detailed further review. In some cases, the bibliography of these retrieved articles provided additional sources. The findings demonstrate multiple research and medical uses and applications of TDC measurements, focusing on detecting and quantifying localized edema and lymphedema in multiple target sites. These include the upper and lower extremities, breasts, and trunk as regions involved in medical conditions causing lymphedema. In addition, the findings suggest that TDC evaluations are a convenient, non-invasive method to study and evaluate other conditions impacting skin, including diabetes mellitus and skin wounds or ulcers. Its ability to detect aspects of tissue changes simply and rapidly at almost any anatomical location makes it a useful tool for investigating multiple dermatological conditions and their treatment as future applications of this method.