Ultrasound Elastography as an objective diagnostic measurement tool for lymphedema of the treated breast in breast cancer patients following breast conserving surgery and radiotherapy
Background: Lymphedema of the operated and irradiated breast is a common complication following early breast cancer treatment. There is no consensus on objective diagnostic criteria and standard measurement tools. This study investigates the use of Ultrasound Elastography as an objective quantitative measurement tool for the diagnosis of parenchymal breast edema.
Patients and Methods The elasticity ratio of the subcutis, measured with Ultrasound Elastography, was compared with High-Frequency Ultrasound parameters and subjective symptoms in twenty patients, bilaterally, prior to and following breast conserving surgery and breast irradiation.
Results: Elasticity ratio of the subcutis of the operated breast following radiation therapy increased in 88.9 % of patients, was significantly higher than prior to surgery, unlike the non operated breast and significantly higher than the non operated breast, unlike pre operative results. These results were significantly correlated with visibility of the echogenic line, measured with High-Frequency Ultrasound. Big pre operative bra cup size was a significant risk factor for the development of breast edema.
Conclusions: Ultrasound Elastography is an objective quantitative measurement tool for the diagnosis of parenchymal breast edema, in combination with other objective diagnostic criteria. Further research with longer follow-up and more patients is necessary to confirm our findings.