APPLICATION OF ULTRASOUND ELASTOGRAPHY FOR BREAST CANCER-RELATED LYMPHEDEMA DIAGNOSIS AND STAGING: A SYSTEMATIC REVIEW

Hosseini, Seyyed Mohammad; Bahanesteh, Amir Hossein; Yarmohammadi, Hossein; Mahdavi Anari, Seyed Fattah

doi:10.22034/icrj.2022.173694

APPLICATION OF ULTRASOUND ELASTOGRAPHY FOR BREAST CANCER-RELATED LYMPHEDEMA DIAGNOSIS AND STAGING: A SYSTEMATIC REVIEW

Authors

Seyyed Mohammad Hosseini

Amir Hossein Bahanesteh

Hossein Yarmohammadi

Seyed Fattah Mahdavi Anari

Medical Students Research Committee, Shahed University, Tehran, Iran

10.22034/icrj.2022.173694

Abstract

Background:
Breast cancer-related lymphedema (BCRL) affects negatively the quality of life and imposes a significant burden on breast cancer survivors. Despite the importance, diagnosis of lymphedema still is based on clinical findings and recent research has studied ultrasound application for more accurate diagnosis and staging.
Methods:
An electronic search was performed on pubmed and scopus on 20/11/2021. Original studies investigating BCRL diagnosis or staging with ultrasound were considered eligible. Other types of lymphedema or articles in other languages than english were excluded. Data regarding participants, method, and findings were extracted from included articles after screening.
Results:
Among 16 included articles, four had used ultrasound for both diagnosis and staging. Two studies had compared affected limbs with healthy controls, while the other had compared with unaffected limbs. Strain and shear wave velocity imaging was reported in 14 and one studies, respectively; while one study had used both imaging. Circumference measurement and bioimpedance analysis were used as other assessment tools in four and three articles, respectively. Different findings were reported in included articles. In 13 articles, the thickness of cutis and subcutis of the affected limb was significantly higher. Also, reduction incompressibility of skin was reported in two studies. Correlation with findings of other assessment tools was also investigated; as a significant correlation of ultrasonography findings with circumference, and bioimpedance analysis was reported in four and three articles, respectively. Moreover, four included articles reported a significant correlation between ultrasonography findings and higher stages of lymphedema.
Conclusion:
Current evidence supports the usefulness of ultrasonography in BCRL diagnosis and staging. Future researches are needed to focus on the early application of ultrasonography for latent BCRL after the surgery.

Keywords

Lymphedema

Ultrasounds

Elastography

Diagnosis