Evaluation of BIS for Quantification of Lymphedema

Completed

Brief Summary: The purpose of this study is to determine whether measuring the fluid in your arms using Bioimpedance Spectroscopy is as effective at detecting and monitoring lymphedema as measurements with the Perometer. The investigators will also evaluate any symptoms you may experience in your arms during and after treatment for breast cancer with a questionnaire.

Detailed Description: During the study whenever you have an arm volume measurement using the Perometer, we will also measure the fluid in your arms using Bioimpedance Spectroscopy. These measurements are made by passing a harmless electrical signal of very low strength through your body to determine the difference in the amount of fluid in each arm. The test is simple and painless, and takes about 3 minutes. In addition, whenever you have an arm measurement, you will be asked to complete a questionnaire. While completing the questionnaire, you can skip any questions you do not wish to answer. The questionnaires will take about 10 minutes to complete. Arm measurements with the Perometer and Bioimpedance Spectroscopy and completion of the questionnaire will occur every 4-7 months when you are at MGH for regular medical visits.

Recruitment & Eligibility

Inclusion Criteria

Histologically or cytologically confirmed invasive or in-situ carcinoma of the breast
Participants must have undergone sentinel node mapping or axillary dissection
Life expectancy of greater than 1 year.
Willingness to comply with required follow up Perometer and BIS measurements and completion of LEFT-BC questionnaire

Exclusion Criteria

Patients who have known metastatic disease or other locally advanced disease in the thoracic or cervical regions
Any patient who will not be returning routinely for follow-up at MGH or DFHCC
Participants with known brain metastases will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events
History of primary lymphedema
History of prior surgery or radiation to the head, neck, upper limb, or trunk
Participants who have evidence that axillary lymph node malignancy is causing lymphedema due to recurrence as per physician discretion
Any patient who has bilateral lymph node mapping or dissection
Any patient with a current case of cellulitis
Patients with a history of a different malignancy are ineligible except for the following circumstances. Individuals with a history of other malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be at low risk for recurrence of that malignancy. Individuals with the following cancers are eligible if diagnosed and treated within the past 5 years: cervical cancer in situ, and basal cell or squamous cell carcinoma of the skin

Arm && Interventions

Group	Intervention	Description
BIS	Bioimpedance Spectroscopy	Subjects evaluated using Bioimpedance Spectroscopy

Primary Outcome Measures

Name	Time	Method
Correlation of Impedance Ratios Obtained Through Bioimpedance Spectroscopy (BIS) With Perometric Relative Arm Volume Change (RVC)	5 years	Correlation of volumetric measurements obtained using Perometry with impedance ratios obtained through BIS at the baseline examination and during follow-up visits. Impedance ratios will also be correlated with symptoms indicated in the LEFT-BC questionnaires completed during each examination. Volumetric arm measurements from perometry will be quantified using the RVC formula, which will be compared with impedance ratios calculated using the BIS device software.

Secondary Outcome Measures

Name	Time	Method
Compare Relationship Between Lymphedema Diagnostic Criteria Corresponding to BIS, Perometry, and Self-reported Symptoms	5 years	Relationship among diagnostic criteria pertaining to BIS, perometry, and self-reported symptoms. A change of \>3 Standard Deviations in impedance ratios compared to pre-surgical baseline is considered diagnostic for lymphedema when BIS is utilized. A relative volume change of \>5% - \>10% compared to baseline is considered lymphedema by perometry. Self-report of symptoms including feelings of swelling, heaviness, and tightness are often considered as criteria for lymphedema.