Fluid changes
breast cancer-related lymphedema, swelling
SKIN
Limb volume measurements, especially in the short term, provide a proxy measure of fluid changes. These were taken with an optoelectronic system (Perometer 400T; Pero-System Messgeräte GmbH, Wuppertal, Germany).Extracellular fluid (ECF) changes in the whole limb were assessed by bioimpedance spectroscopy (BIS) of the individual lower limbs,Local tissue water (LTW) was assessed by measuring tissue dielectric constant (TDC) with a Moisture Meter D (Delfin Technologies, Kuopio, Finland), at specific anatomical sites (on dorsum of foot, medial malleolus, below patella, above patella, inguinal ligament, and lower abdominal wall) using two probes that measure LTW to depths of 2.5 and 5 mm, respectively.Ultrasound with a 5–16 MHz probe (Fujifilm Sonosite, Bothell, WA, USA), was used to measure skin thickness at the same anatomical sites as TDC. Skin thickness (epidermis and dermis) has previously been shown to be increased uniformly around the arm in breast cancer-related lymphedema and correlates strongly with the degree of swelling.