Characterizing early postoperative changes in body composition in patients with secondary lymphedema after breast cancer surgery: potential screening indicators for preventive intervention.

ABSTRACT

[Purpose] To characterize changes in the body composition of individuals with secondary lymphedema that developed in the early postoperative period after breast cancer surgery, before the manifestation of volume increase in the affected limb, and to test its potential as a screening indicator for preventive intervention. [Participants and Methods] A total of 219 patients with breast cancer who underwent axillary lymph node dissection and sentinel lymph node biopsy were included in this study. Body composition (extracellular water content, extracellular water content ratio, low-frequency impedance value, and phase angle) was evaluated using bioelectrical impedance analysis before surgery and three and six months after surgery. Changes in the body composition of the affected limb over time were compared between the lymphedema- and non-lymphedema-affected groups. [Results] Sixteen patients who developed lymphedema six months after breast cancer treatment showed significant changes in all body composition parameters at three months postoperatively, compared to those who did not develop lymphedema. [Conclusion] In patients with upper extremity lymphedema that develops within six months after breast cancer surgery, increases in extracellular water content, extracellular water content ratio, low-frequency impedance, and phase angle may precede apparent volume increases. Our findings suggest the usefulness of these parameters as screening indicators for early treatment triaging.