Role of handedness on forearm skin tissue dielectric constant (TDC) in relation to detection of early‐stage breast cancer‐related lymphedema

Abstract

skin tissue dielectric constant (TDC) measurements help assess local skin water to detect incipient early-stage lymphedema subsequent to breast cancer treatment-related lymphedema. However, presurgery measurements are not always obtained and assessments for evolving lymphedema are only made after surgery. Thus, subsequent TDC assessments may be biased in an unknown way dependent on a patient's handedness in relation to the at-risk arm. We investigated this issue by comparing TDC values in dominant and non-dominant volar forearms of 31 left-handed women and 31 right-handed women (age range 24-84 years). Body fat and water percentages were assessed by bioimpedance at 50 KHz. Results showed that TDC values of dominant versus non-dominant arms did not significantly differ for left-handers or for right-handers. There was also no statistically significant difference in absolute TDC values between left- and right-handers or a statistically significant difference in dominant-to-non-dominant arm ratios between left- and right-handers. For the composite data set (N = 62), TDC values for dominant and non-dominant arms were, respectively, 30·0 ± 4·6 and 29·6 ± 4·2 and the dominant-to-non-dominant arm TDC ratio for combined left- and right-handers was 1·015 ± 0·075. These results suggest that handedness is not a major factor when assessing lymphedema status in women who have previously been treated for breast cancer but for whom pretreatment TDCvalues have not been obtained. Moreover, these results suggest that threshold ratios of incipient subclinical unilateral lymphedema based on interarm TDC ratios apply independent of a patient's handedness for the site and tissue depths herein measured.

Assessment of local tissue water in the arms and trunk of breast cancer survivors with and without upper extremity lymphoedema

“…Second, limited information is available on the optimal assessment sites. We chose all but one site based on current literature (Mayrovitz, Fasen, et al, 2017; Mayrovitz et al, 2015a,b; Weingrad and Davey 2014; Mayrovitz et al, 2008a), clinical experience, and consultation with LE therapists. Of note, the choice of the first dorsal web space may not be the ideal location to evaluate hand LTW.…”

“…We did not factor in dominance in our analysis of between-limb comparisons of TDC values. In a recent study of the effect of handedness in healthy female adults (Mayrovitz et al, 2018), limb dominance had no effect on TDC values or ratios. Second, limited information is available on the optimal assessment sites.…”

“…To date, most of the studies that used TDC have assessed healthy women (Mayrovitz, Corbitt, et al 2017; Mayrovitz, Fasen, et al 2017) and upper extremity swelling in women with and without breast cancer-related LE (Mayrovitz et al, 2015a,b; Mayrovitz et al, 2014; Mayrovitz et al, 2008a,b; Lahtinen et al, 2015; Bakar et al, 2018). Findings from these studies suggest that TDC can reliably detect inter-limb differences in LTW in women at risk for and with LE (Mayrovitz et al 2015a; Mayrovitz et al, 2014; Bakar et al, 2018; Lahtinen et al, 2015).…”

Can 3D Camera Imaging Provide Improved Information to Assess and Manage Lymphoedema in Clinical Practice?

“…Tissue Dielectric Constant (TDC) measurements evaluate local tissue water in the skin and subcutaneous tissues via a non-invasive device (Mayrovitz, Carson, & Luis, 2010;Mayrovitz, Corbitt, Grammenos, Abello, & Mammino, 2017a;Mayrovitz, Fasen, Spagna, & Wong, 2018a) and are performed at 300-megahertz (MHz) frequency using a concentric transmission line measurement technique. This, in turn, reflects electromagnetic energy dependant on the dielectric constant of the tissue, which is dependent on the amount of free and bound water in the tissue volume.…”

“…TDC is a quick measurement and takes about 10 seconds for a reading, which is taken at multiple sites, measuring locally, thus making it a clinically efficient technique (Mayrovitz, Davey, & Shapiro, 2008;Mayrovitz, Davey, & Shapiro, 2009a;Mayrovitz, 2010;Mayrovitz et al, 2010;Czerniec, Ward, & Kilbreath, 2015;Lahtinen, Seppala, Viren, & Johansson, 2015;Mayrovitz et al, 2015;Mayrovitz et al, 2017b;Mayrovitz et al, 2018a;De Vrieze et al, 2020). Single measurements are as effective as triplicate measurements on the forearm and upper arm, thus less time consuming to measure within a clinical setting (Mayrovitz et al, 2009a;Mayrovitz et al, 2016;De Vrieze et al, 2020).…”