What type of study is this?

This is a Cross-Sectional Study study.

September 26, 2025Open Access

Screening for Breast Cancer-Related Lymphedema: A Cross-Sectional Study Using Ultrasound and Bioelectrical Impedance Analysis

JFJialin FanRutgers, The State University of New Jersey YQYu QuGansu Academy of Agricultural Sciences YLYujuan LiuChinese Academy of Sciences

Key Points

Increased lymphatic flow velocity, decreased phase angle, and reduced grip strength are early indicators of breast cancer-related lymphedema.
The study found optimal diagnostic thresholds for lymphedema, achieving sensitivities up to 92.3% with specific biometric measures.
Statistical analysis revealed correlations between age, extracellular water, and grip strength in relation to breast cancer-related lymphedema.
Identifying early risk factors can enable timely interventions, preventing the progression of lymphedema in patients.

Abstract

Abstract Background Breast cancer-related lymphoma (BCRL) develops in 25% of breast cancer patients following treatment. It is a chronic condition where swelling persists despite interventions like compression hosiery and manual lymphatic drainage. Aim This study aimed to determine factors associated with early-stage lymphedema in women with breast cancer, investigate the relationship between lymphedema, lymphatic flow velocity, and body composition, and explore potential mechanisms for preventing BCRL. Design: Cross-sectional study. Setting: Inpatient rehabilitation unit Population: Thirty-four female patients with confirmed BCRL (age: 49.6 ± 8.7 years; height: 158.6 ± 4.1 cm; weight: 60.2 ± 9.8 kg) and 26 healthy controls (age: 50.5 ± 15.1 years; height: 160.9 ± 5.9 cm; weight: 62.9 ± 10.1 kg) were enrolled between 2024 and 2025. Methods Lymphatic duct diameter and flow velocity at the right venous angle were measured using ultrasound. Hand grip strength was assessed using a dynamometer, and body composition was analyzed using a bioimpedance analyzer (InBody 770; InBody Co., Seoul, Korea). Statistical analyses included paired t-tests to compare BCRL and control groups and Spearman's correlation for associations between clinical characteristics. Receiver operating characteristic analysis was used to determine diagnostic thresholds for BCRL. Results Compared to healthy controls, the BCRL group showed significantly higher lymphatic flow velocity, lower phase angle, and reduced grip strength (all p < 0.01). Age was positively correlated with extracellular water (ECW) but negatively with phase angle, while grip strength was positively correlated with phase angle. The optimal diagnostic cutoffs for lymphedema were: lymphatic flow velocity ≥ 7.7 cm/s (35.3% sensitivity, 96.2% specificity), phase angle ≤ 4.05° (92.3% sensitivity, 70.6% specificity), and grip strength ≤ 18.1 N (88.5% sensitivity, 67.6% specificity). Conclusion Increased lymphatic flow velocity, decreased phase angle, and reduced grip strength were significant early-stage indicators of BCRL. Clinical rehabilitation impact: Identifying early risk factors for lymphedema can help clinicians understand its mechanism and enable timely interventions to prevent its progression.

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