{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:22:24Z","timestamp":1779297744103,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We reviewed serial bioimpedance measurements in order to quantify the relationship between changes in these scores and a patient's risk for developing breast cancer-related lymphedema (BCRL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      From April 2010 through November 2016, 505 patients were prospectively evaluated using bioimpedance spectroscopy (BIS\/L-Dex). Patients received preoperative and postoperative L-Dex measurements and were categorized based upon risk for BCRL with respect to axillary staging procedure, radiation use, taxane use, and body mass index (BMI). L-Dex change was associated with the type and number of BCRL risk factors. Both axillary lymph node dissection (ALND) and regional nodal irradiation (RNI) were associated with a greater change in L-Dex (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), although elevated BMI was not associated. The median, maximal change in L-Dex for patients treated with ALND, RNI, and taxanes was 16.7 versus 5.2 for ALND alone and 3.7 for sentinel lymph node biopsy (SLNB) alone (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016). In a model using all four risk factors to predict the maximal change in L-Dex, ALND and RNI remained significantly associated with maximum change (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The time required to reach maximal change in L-Dex was shorter in patients treated with ALND or RNI (the time for 25% of patients achieving an L-Dex \u22657 was 4.3 months for ALND, RNI, and taxanes patients versus 30.8 months for SLNB-alone patients).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Risk factors for development of BCRL were associated with both the magnitude and timing of change in L-Dex scores. These findings demonstrate the utility of serial L-Dex measurements in providing an objective assessment of a patient's lymphedema status and the value of L-Dex serial measurements to assist in monitoring patients for the development of BCRL. This supports the clinical utilization of serial L-Dex scores to follow patients at risk for BCRL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2017.0078","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T15:30:21Z","timestamp":1534951821000},"page":"533-537","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Correlation of Bioimpedance Spectroscopy with Risk Factors for the Development of Breast Cancer-Related Lymphedema"],"prefix":"10.1177","volume":"16","author":[{"given":"Frank","family":"Vicini","sequence":"first","affiliation":[{"name":"21st Century Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chirag","family":"Shah","sequence":"additional","affiliation":[{"name":"Taussig Cancer Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pat","family":"Whitworth","sequence":"additional","affiliation":[{"name":"Nashville Breast Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Walker","sequence":"additional","affiliation":[{"name":"Walker Bioscience"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Shi","sequence":"additional","affiliation":[{"name":"Walker Bioscience"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,12,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21387"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62038-9"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20001"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2013.05.001"},{"key":"e_1_3_4_6_2","first-page":"1","article-title":"The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology","volume":"46","author":"International Society of Lymphology","year":"2013","unstructured":"International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology, 2013; 46:1\u201311.","journal-title":"Lymphology"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.05.043"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21535"},{"key":"e_1_3_4_9_2","first-page":"1209","article-title":"Risk of lymphedema after regional nodal irradiation with breast conservation therapy","volume":"55","author":"Coen JJ","year":"2002","unstructured":"Coen JJ, , Taghian AG, , Kachnic LA, et al. Risk of lymphedema after regional nodal irradiation with breast conservation therapy. Int J Radiat Oncol Biol Phys, 2002; 55:1209\u20131215.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2014.0030"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-014-3137-x"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12647"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23494"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b5396"},{"key":"e_1_3_4_15_2","unstructured":"National Comprehensive Cancer Network. Breast Cancer (Version 2.2016). http:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/breast.pdf Accessed September23 2017."},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2010.0014"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2008.1003"},{"key":"e_1_3_4_18_2","first-page":"2","article-title":"Early diagnosis of lymphedema using multiple frequency bioimpedance","volume":"34","author":"Cornish BH","year":"2001","unstructured":"Cornish BH, , Chapman M, , Hirst C, et al. Early diagnosis of lymphedema using multiple frequency bioimpedance. Lymphology, 2001; 34:2\u201311.","journal-title":"Lymphology"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2012.01.004"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2016.00192"},{"key":"e_1_3_4_21_2","first-page":"184","article-title":"The use of bioimpedance spectroscopy to monitor therapeutic intervention in patients treated for breast cancer related lymphedema","volume":"46","author":"Shah C","year":"2013","unstructured":"Shah C, , Vicini F, , Beitsch P, et al. The use of bioimpedance spectroscopy to monitor therapeutic intervention in patients treated for breast cancer related lymphedema. Lymphology, 2013; 46:184\u2013192.","journal-title":"Lymphology"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.35.15_suppl.10117"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4451-x"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12939"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.691"},{"key":"e_1_3_4_26_2","first-page":"85","article-title":"L-Dex ratio in detecting breast cancer-related lymphedema: Reliability, sensitivity and specificity","volume":"46","author":"Fu M","year":"2013","unstructured":"Fu M, , Cleland C, , Guth A, et al. L-Dex ratio in detecting breast cancer-related lymphedema: Reliability, sensitivity and specificity. Lymphology, 2013; 46:85\u201396.","journal-title":"Lymphology"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2014.0035"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1016591121762"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2016.1191668"},{"key":"e_1_3_4_30_2","unstructured":"Bioimpedance spectroscopy versus tape measure in prevention of lymphedema: NCT02167659. 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