Issue 24-6, 2025

Original article

https://doi.org/10.38025/2078-1962-2025-24-6-42-50

Body Composition Analysis as a Comprehensive Method for Assessing the Effectiveness of Medical Rehabilitation for Lymphedema Associated with Radical Breast Cancer Treatment

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ORCIDValeriia A. Vasileva*, ORCIDTatiana V. Konchugova, ORCIDTatiana V. Apkhanova, ORCIDOlga M. Musaeva, ORCIDValentina A. Morunova, ORCIDTatiana V. Marfina, ORCIDVladislav I. Koptev, ORCIDLarisa A. Marchenkova

National Medical Research Center for Rehabilitation and Balneology, Moscow, Russia


ABSTRACT

INTRODUCTION. Upper limb lymphedema is a common and disabling complication following radical breast cancer treatment, with a prevalence of 20–40 %. Although volumetry remains the gold standard for diagnosing limb lymphedema, it cannot differentiate between lymphatic edema and adipose hypertrophy. Bioimpedance analysis (BIA) offers a more comprehensive approach to assessing body composition. However, the impact of complex rehabilitation programs on multi-compartment body composition in postmastectomy upper limb lymphedema has not been sufficiently studied.

AIM. To investigate the effect of a comprehensive medical rehabilitation program, including laser therapy, magnetic therapy, exercise therapy, intermittent pneumatic compression, and cyclic trainer exercises, on body composition parameters assessed by BIA in patients with upper limb lymphedema, associated with radical mastectomy.

MATERIALS AND METHODS. A cross-sectional study included 30 women aged 35–75 years with post-mastectomy lymphedema. Over 10 days, patients underwent comprehensive rehabilitation alongside a high-protein diet. The effectiveness assessment included anthropometry (circumferences of upper limb segments) and BIA of body composition before and after treatment.

RESULTS. A statistically significant reduction was observed in the circumferences of all upper limb segments on both arms (p < 0.05), except for the right elbow circumference. The most pronounced changes were noted in the proximal segments. BIA revealed a significant decrease in total (p = 0.00035), extracellular (p = 0.00008), and intracellular fluid (p = 0.000002), as well as a reduction in waist (p = 0.00004) and hip circumference (p = 0.0003). Positive changes in lean body mass (p = 0.0018) and musculoskeletal mass (p = 0.004), along with an improvement in basal metabolic rate (p = 0.026), were observed.

DISCUSSION. The results demonstrate the effectiveness of the comprehensive approach in reducing lymphedema and normalizing fluid homeostasis. The pronounced effect in the proximal segments is consistent with literature data on the importance of restoring proximal lymphatic flow. The observed positive dynamics of changes in skeletal muscle mass (p = 0.004), active cell mass (p = 0.0018) and basal metabolic rate (p = 0.026) may indicate an increase in the level of metabolism in skeletal muscles due to an increase in the overall level of physical activity after the rehabilitation course.

CONCLUSION. The comprehensive medical rehabilitation program is an effective means of correcting not only local manifestations of lymphedema but also systemic body composition disorders. The combined use of BIA and traditional anthropometry provides an objective multi-component assessment of rehabilitation effectiveness.


KEYWORDS: body composition, medical rehabilitation, chronic lymphedema, pneumatic compression, mastectomy, breast cancer

FOR CITATION: Vasileva V.A., Konchugova T.V., Aphanova T.V., Musaeva O.M., Morunova V.A., Marfina T.V., Koptev V.I., Marchenkova L.A. Body Composition Analysis as a Comprehensive Method for Assessing the Effectiveness of Medical Rehabilitation for Lymphedema Associated with Radical Breast Cancer Treatment. Bulletin of Rehabilitation Medicine. 2025; 24(6):42–50. https://doi.org/10.38025/2078-1962-2025-24-6-42-50 (In Russ.).

FOR CORRESPONDENCE:

Valeriia A. Vasileva, Email: vasilevava@nmicrk.ru


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.