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Objective. Following breast cancer surgery with lymph node removal, women are at risk of developing lymphedema in the upper extremity or trunk. Currently, trunk lymphedema diagnosis relies on a clinical assessment because no quantifable standard method exists. Tissue dielectric constant (TDC) values are quantifable measures of localized skin tissue water and may be able to detect trunk lymphedema. The goal of this study was to (1) compare parameters derived from TDC measurements with those derived from clinically accepted criteria for trunk lymphedema in women following breast cancer surgery and (2) explore the potential utility of TDC to detect trunk lymphedema early in its progression. Methods. This prospective longitudinal study, a secondary analysis from a larger study, observed women with and without clinically determined truncal lymphedema following breast cancer surgery. TDC was measured on the lateral trunk wall at post-surgery weeks 2, 4, 12, and 78 in women who had surgical breast cancer treatment with lymph node removal. Clinical assessment for trunk lymphedema was determined at 78 weeks by a lymphedema expert. Comparison of TDC measurements in women with and without clinical trunk lymphedema was analyzed. Results. Clinical assessment identified trunk lymphedema in 15 out of 32 women at 78 weeks. These women had TDC ratios statistically higher than women without truncal lymphedema. Conclusion. The overall findings indicate that TDC has the ability to quantify trunk lymphedema and might be valuable in early detection. Impact. TDC may be a beneficial tool in the early detection of breast cancer--related trunk lymphedema, which could trigger intervention. Lay Summary. A new device may help recognize trunk lymphedema in patients with breast cancer so they could receive appropriate treatment., Breast cancer--related lymphedema (BCRL) is a negative sequela of breast cancer treatment. Reported incidence rates of BCRL vary from 6% to 94% (.1,2) While lymphedema incidence has been reported less [...]

Background. Axillary web syndrome (AWS) can develop following breast cancer surgery and presents as a tight band of tissue in the axilla with shoulder abduction. Objective. The objectives were to determine the prevalence and natural history of AWS and the association between AWS and function, range of motion, pain, lymphedema, and body mass index (BMI). Design. This study was a longitudinal prospective cohort study utilizing a repeated measures design. Methods. Axillary web syndrome, function, shoulder range of motion, pain, and lymphedema (using circumference, bioimpedance spectroscopy, tissue dielectric constant) were assessed in women at 2, 4, and 12 weeks and 18 months following breast cancer surgery. Prevalence of AWS and the association with the measured outcomes were analyzed. Results. Thirty-six women agreed to participate in the study. The cumulative prevalence of AWS was 50% (18/36) at 18 months following breast cancer surgery. AWS was identified as a risk factor for reduced function. Women with AWS had statistically reduced range of motion, lower BMI, and higher number of lymph nodes removed compared to the non-AWS group. Forty-one percent (13/32) of women had AWS at 18 months. AWS reoccurred in 6 women following resolution, and a new case developed beyond the early postoperative period. The overall prevalence of physical impairments ranged from 66% to 97% within the first 18 months following surgery regardless of AWS. Limitations. Limitations include a small sample size and potential treatment effect. Conclusion. AWS occurs in approximately 50% of women following breast cancer surgery. It can persist for 18 months and potentially longer, develop beyond the early postoperative time period, and reoccur after resolution. Clinicians need to be aware of the chronicity of AWS and its association with reduced range of motion and function., Treatment for breast cancer can lead to long-term complications such as reduced function, reduced range of motion (ROM), pain, and lymphedema.1-3 Axillary web syndrome (AWS), or cording, is another complication [...]

Background. Axillary web syndrome (AWS) is a condition that may develop following breast cancer surgery and that presents as a palpable axillary cord of tissue. Objective. The purposes of this study were: (1) to determine the clinical characteristics of AWS related to movement, function, pain, and postoperative edema and (2) to define the incidence of and risk factors for AWS within the first 3 months following breast cancer surgery. Design. This was a prospective cohort study with a repeated-measures design. Methods. Women who underwent breast cancer surgery with sentinel node biopsy or axillary lymph node dissection (N=36) were assessed for AWS, shoulder range of motion, function, pain, and postoperative edema (using girth measurements, bioimpedance, and tissue dielectric constant) at 2, 4, and 12 weeks. Demographic characteristics were used for risk analysis. Results. Seventeen women (47.2%) developed AWS, and AWS persisted in 10 participants (27.8%) at 12 weeks. Abduction range of motion was significantly lower in the AWS group compared with the non-AWS group at 2 and 4 weeks. There were no differences between groups in measurements of function, pain, or edema at any time point. Trunk edema measured by dielectric constant was present in both groups, with an incidence of 55%. Multivariate analysis determined lower body mass index as being significantly associated with AWS (odds ratio=0.86; 95% confidence interval=0.74, 1.00). Limitations. Limitations included a short follow-up time and a small sample size. Conclusion. Axillary web syndrome is prevalent following breast/axilla surgery for early-stage breast cancer and may persist beyond 12 weeks. The early consequences include movement restriction, but the long-term effects of persistent AWS cords are yet unknown. Low body mass index is considered a risk factor for AWS., Breast cancer surgery with axillary lymph node dissection (ALND) or sentinel node biopsy (SNB) is considered standard treatment for management of earlystage breast cancer. (1) Breast cancer surgery can result [...]

Body composition refers to the proportions of adipose tissue (fat) and lean tissue in the body; lean tissues include bones, muscles, and fluids such as blood. The body can be divided into fat and fat-free tissues, for example a person who has 25 percent body fat has 75 percent fat-free body mass. The percent of body fat is now being used as an indicator of how fit a person is; it gives more information than body weight, which can be misleading in an individual who has unusually large bones or is very muscular. The goal of body composition analysis is to determine whether the person should lose fat to reach the ideal body fat percentage range, which is different for men and women. Researchers have developed several methods for estimating body composition in the individual. In this study, the accuracy of a new method known as total-body electrical conductivity (TOBEC) was tested. TOBEC utilizes a large coil, driven by a radio frequency, which creates an electromagnetic field. The individual passes through the field, and the body's conductive mass is determined; fat-free mass can be calculated from the result. TOBEC was used to estimate fat-free mass in 114 middle-aged and elderly subjects (aged 35 to 90 years). The results of TOBEC were compared with those of two other methods of body composition analysis, densitometry (underwater weighing) and hydrometry. Based on this comparison, TOBEC appeared to be highly accurate; the estimated fat-free mass was very similar using the three different methods. TOBEC may be particularly useful with older individuals because it is not influenced by bone mineralization, which typically decreases with age. (Consumer Summary produced by Reliance Medical Information, Inc.)

This study examined the visual similarity of American manual alphabet letters to their graphic counterparts. Forty-five nondisabled undergraduate college students, who were unfamiliar with the manual alphabet, viewed each of the manual alphabet letters from three angles. Eleven of the 26 manual letters (42%) were correctly identified at one or more viewing angles by more than 50% (23/45) of the subjects. Perhaps more importantly, all of the manual letters were perceived to have some positive degree of similarity to their corresponding graphic letters, and for 65% (17/26) of the manual letters, the subjects perceived a moderate to a very strong degree of similarity. These findings suggest that with minimal training, manual alphabet letters may potentially provide a visual cue for phonologically segmenting and sequencing oral and written language. Implications on the instructional use of fingerspelling to facilitate phonemic awareness for high-risk or reading-impaired children and augmented communicators learning and using graphic letters are further discussed.

Presents a letter to the editor in response to Michael Smith's article about mathematics curriculum.