Segmental measurement of breast cancer-related arm lymphoedema using perometry and bioimpedance spectroscopy

Purpose: To determine if bioimpedance spectroscopy (BIS) could detect localised lymphoedema of the arm and to compare BIS measurements with equivalent measures of limb volume by perometry. Methods: Women with mild to severe upper limb lymphoedema (n=29) and women with no history of lymphoedema (n=11) participated. Commencing at the ulnar styloid of the wrist, 4x10 cm segment measurements were made of each arm using both BIS and perometry. Results: Average BIS inter-limb ratios for the total arm and each arm segment were higher than comparable perometry measures in women with lymphoedema, but similar to perometry measures for women without lymphoedema. Limits of agreement analysis showed that the mean difference between methods varied according to segment measured, ranging from 8.5% for the uppermost segment of the arm to 16.6% for the forearm segment just below the elbow. For all limb segments, there was a positive bias towards BIS measurements, which increased as lymphoedema severity increased. Conclusion: BIS can be used for localised measurement of lymphoedema. Because it is specific to extracellular fluid, BIS is more sensitive to localised lymphoedema than perometry.