Türkan Turgay1, Tuba Denkçeken2, Göktürk Maralcan3

1Department of Physical Medicine and Rehabilitation, Sanko University Faculty of Medicine, Gaziantep, Turkey
2 Department of Biophysics, Sanko University Faculty of Medicine, Gaziantep, Turkey
3Department of General Surgery, Sanko University Faculty of Medicine, Gaziantep, Turkey


Objective: The correlation between lymphedema severity and stages determined by standard diagnostic methods and Bioimpedance Spectroscopy (BIS) technique was examined in breast cancer-related lymphedema (BCRL) patients.

Material and Methods: The bioimpedance analyzer device was connected to the 1.0 cm disc electrodes which were connected to the affected and unaffected (healthy) arm of the patients. We evaluated the performance of the impedance (Z) at multiple frequencies (5-50-100-200 kHz) and phase angle (PA), resistance (R), and reactance (XC) at 50 kHz on the lymphedema severity and stages. Bioimpedance measurements were applied to all volunteers in cooperation with the Physical Therapy and Rehabilitation Department. In this study, the correlation between BCRL severity and stages and bioimpedance values was examined.

Results: A total of 31 female patients were recruited to compare the BIS technique with standard diagnostic techniques. The severity of lymphedema was found among the patients as follows; mild 14 (45.2%), moderate 10 (32.3%), and severe 7 (22.6%). The stage distribution of volunteers was; 15 (48.4%) patients in Stage 0, 10 (32.3%) patients in Stage 1, 5 (16.1%) patients in Stage 2, and 1 (3.2%) patient in Stage 3. The ratio of affected and unaffected arm bioimpedance mean values were calculated. Although, this ratio at 50-100-200 kHz Z and 50kHz R were significantly correlated with the lymphedema stages (p< 0.05), there was no correlation and significant difference between the ratio of the bioimpedance values and lymphedema severity (p> 0.05).

Conclusion: The BIS technique is timesaving and can determine lymphedema stages. We found a significant correlation between BCRL stages and BIS, and it appears that BIS is an appropriate, inexpensive, simple, and noninvasive technique for detecting the stages of BCRL.

Keywords: Bioimpedance spectroscopy, breast cancer, lymphedema, stages, severity

Cite this article as: Turgay T, Denkçeken T, Maralcan G. The role of bioimpedance spectroscopy method in severity and stages of breast cancer-related lymphedema. Turk J Surg 2022; 38 (1): 11-17.


Ethics Committee Approval

This study was conducted in accordance with the amended Declaration of Helsinki. The institutional review board (Sanko University Ethics Committee (Decision No: 2020/01-01) approved the study, and all participants provided written informed consent.

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - T.T. T.D.; Design - T.T. T.D.; Supervision - T.T. T.D.; Materials - T.T., G.M.; Data Collection and/or Processing - T.T. T.D.; Analysis and/or Interpretation - T.T.; Literature Search - T.T. T.D.; Writing Manuscript - T.T. T.D.; Critical Reviews - All of authors.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.