Postoperative evolution of thickness and echogenicity of cutis and subcutis of patients with and without breast cancer-related lymphedema

Devoogdt, Nele; Pans, Steven; De Groef, An; Geraerts, Inge; Christiaens, Marie-Rose; Neven, Patrick; Vergote, Ignace; van Kampen, Marijke

doi:10.1089/LRB.2013.0028

Title

Postoperative evolution of thickness and echogenicity of cutis and subcutis of patients with and without breast cancer-related lymphedema

Author

Devoogdt, Nele

Pans, Steven

De Groef, An

Geraerts, Inge

Christiaens, Marie-Rose

Neven, Patrick

Vergote, Ignace

van Kampen, Marijke

Abstract

Background: Compared to volume/circumference measurements to diagnose lymphedema, thickening and disturbance of echogenicity of cutis and subcutis associated with the development of lymphedema is measured directly by ultrasonography. The aim of the present study was to investigate the evolution of thickness and echogenicity of cutis and subcutis of the lower and upper arm after axillary dissection for breast cancer and compare patients with and without arm lymphedema. Methods and results: Immediately after the surgery and at 6 and 12 months post-surgery, 42 patients received an ultrasonography of both arms, at the wrist, ventral and dorsal side of the lower arm, and biceps and triceps side of the upper arm. Thickness and echogenicity of cutis and subcutis were determined. Lymphedema was defined as 5.0% or more increase compare to the preoperative value. Eighteen patients had developed lymphedema of the lower arm, and 24 patients of the upper arm. Thickness of the cutis decreased significantly during the postoperative period on the healthy and affected side as well. The difference of cutis thickness between affected and healthy side increased postoperatively in patients with lymphedema and decreased in patients without lymphedema at the wrist and dorsal side of the lower arm. Patients with lymphedema had more frequent disturbance of echogenicity of the cutis at all measurement points. In exception of the triceps, thickness and echogenicity of the subcutis is less obvious disturbed. Sensitivity to detect arm lymphedema by ultrasonography was acceptable for increased subcutis thickness at the ventral lower arm and triceps and disturbed cutis echogenicity at the wrist (67%–100%). Sensitivity for the other measurements was bad. Specificity was for all measurements acceptable (59%–100%). Conclusion: Ultrasonography may be useful to diagnose lymphedema developing after axillary dissection for breast cancer. However, it cannot be used as a separate diagnostic test for lymphedema.

Language

English

Source (journal)

Lymphatic research and biology. - New Rochelle, N.Y.

Publication

New Rochelle, N.Y. : 2014

ISSN

1557-8585 [online]

1539-6851 [print]

DOI

10.1089/LRB.2013.0028

Volume/pages