Abstract
Purpose
Severe lymphedema leads to a decline in quality of life. Skin stiffness is one of the symptoms of lymphedema; however, no objective method has been established to evaluate this symptom. We aimed to examine whether MyotonPRO, which is used to evaluate muscle and fascia stiffness, could evaluate skin stiffness in upper limb lymphedema.
Methods
Female patients with breast cancer-related lymphedema (BCRL) after unilateral breast cancer surgery were included. Stiffness by MyotonPRO and circumference were measured on both sides 5 and 10 cm from the elbow joint of the forearm and upper arm, respectively. Measurements were compared between the normal and lymphedema limbs. History of breast cancer, lymphedema and comorbidities were collected from medical records, and the relationship with skin stiffness was evaluated.
Results
The skin stiffness values of normal and lymphedema limbs were 249 ± 50 and 283 ± 56 N/m (p < 0.001) in the upper arm and 306 ± 44 and 353 ± 64 N/m (p < 0.001) in the forearm, respectively, and were significantly greater in the lymphedema limb. The circumferences of the normal and lymphedema limbs were 27.5 ± 3.6 and 29.1 ± 4.0 cm (p < 0.001) for the upper arm and 23.7 ± 2.4 and 25.1 ± 2.9 cm (p < 0.001) for the forearm, respectively, in which the lymphedema limb was significantly larger. In the multiple regression analysis, diabetes had the greatest effect on the lymphedema limb stiffness.
Conclusion
MyotonPRO can objectively assess chronic skin stiffness in BCRL.