Predictive Values of Upper Extremity Function and Body Composition Parameters for Upper Extremity Lymphedema Occurring within 12 Months after Breast Cancer Surgery

Author(s): Aya Okamichi, Miyoko Watanabe, Kazuo Kurosawa

Purpose: This study aimed to evaluate the values of early postoperative body composition and upper limb function as predictive indicators for the development of breast cancer-related lymphedema (BCRL). Methods: The study included women who underwent axillary lymph node dissection between 2022 and 2024. Extracellular water ratio, low-frequency impedance, and phase angle measurements using segmental multifrequency bioelectrical impedance analysis and shoulder range of motion and grip strength assessments were performed preoperatively and at 1, 3, 6, and 12 months postoperatively. Lymphedema was defined as an increase in limb volume by 10% or more, and the data of the affected and unaffected groups were compared at each time point. Results: The group that developed lymphedema within 6 months had increased extracellular water ratio and decreased low-frequency impedance and phase angle by 3 months relative to the unaffected group. The group that developed lymphedema within 12 months had decreased low-frequency impedance and phase angle by 6 months relative to the unaffected group. The range of external shoulder rotation was only significantly reduced for the lymphedema group at 12 months. The grip strengths of the affected and unaffected groups did not differ at any time point. Conclusion: Body composition changes were observed before an increase in limb volume in patients who developed lymphedema within 12 months after breast cancer surgery. Restriction of shoulder range of motion was likely secondary to lymphedema progression. Body composition measures are useful for predicting lymphedema progression and may facilitate early preventive interventions as screening indicators.