Evaluation of Elastographic Parameters in Patients with Breast Cancer-Related Lymphedema and Examination of Their Relationship with Clinical Data

Background: To evaluate the stiffness of the skin and subcutaneous tissues of the arm and forearm of patients with breast cancer-related lymphedema using shear-wave elastography (SWE) and to investigate the relationship between the patients' symptoms. Methods and Results: Both lymphedematous and unaffected upper extremities of 72 patients (72 lymphedematous and 72 unaffected extremities) and 72 upper extremities of 36 controls (72 healthy extremities) were included in the study. The stiffness of the skin and subcutaneous tissues of all extremities was evaluated with SWE. The patients' pain, tension, weight, and stiffness symptoms associated with lymphedema were questioned using a numerical scale. The patients' functionality and participation in daily life activities were evaluated. The skin stiffness of the affected extremity was higher and the subcutaneous tissue stiffness was lower in patients than in controls (p < 0.05). The skin stiffness of the affected forearm was higher and the subcutaneous tissue stiffness of the affected arm and forearm was lower than their healthy extremities (p < 0.05). Quick Disabilities of Arm, Shoulder, and Hand and Life Impact Scale; were negatively correlated with arm and forearm subcutaneous tissue stiffness and positively correlated with forearm skin stiffness. The decrease in subcutaneous tissue stiffness of the arm was associated with heaviness sensation, the increase in skin stiffness of the forearm was associated with tightness, and the decrease in subcutaneous tissue stiffness of the forearm was associated with tightness, heaviness, and stiffness sensations. Conclusion: The results of this study suggest that SWE measurements can be useful for diagnosis and follow-up of patients.