NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Survivorship

Clinical Evidence

Extensive clinical evidence shows that using ImpediMed’s bioimpedance spectroscopy (BIS) technology for early detection and intervention reduces the impact of chronic lymphedema on breast cancer patients.

It is Well Established that Breast Cancer Related Lymphedema (BCRL) can be Resolved with Early Detection and Intervention

Opportunity for Prevention is Before Noticeable Swelling Occurs

Lymphedema develops in stages, and a university of Kansas study found that when lymphedema is detected at stage 0 or stage 1 it is reversible, but in stages 2 and 3 it is not. These findings demonstrate how early conservative intervention and prospective monitoring with BIS can significantly lower rates of BCRL and persistent BCRL (pBCRL).¹

It is Well Established that Breast Cancer Related Lymphedema (BCRL) can be Resolved with Early Detection and Intervention

ImpediMed’s BIS Technology is Most Effective Method for Early Lymphedema Detection

The PREVENT Trial involved 10 centers across the US and Australia and was the largest randomized controlled trial (RCT) to assess lymphedema prevention in breast cancer patients.

Learn More About PREVENT

Triggers and Interventions

ImpediMed’s BIS technology is more precise and reliable than tape measure in detecting lymphedema (LE), as there are statistically significantly fewer triggers and interventions for those assessed with BIS compared to tape measure (p=0.011)2.

Progression to Chronic Lymphedema

Additionally, with early detection using BIS technology and intervention there is significantly lower progression to chronic lymphedema compared to using tape measure (p=0.016), which is the primary endpoint result2.


Review the Strong Literature Included in our Clinical Evidence Summaries for Lymphedema Prevention Program.


Read More About L-Dex in our Clinical Evidence Summaries.


Discover PREVENT, the Largest Randomized Trial to Assess Lymphedema Prevention!

Lymphedema prevention
L-Dex detection limit
Validation studies
Economics quality of life


Complicated breast cancer-related lymphedema: evaluating health care resource utilization and associated costs of management.

Basta, M.N., et al.

Complicated lymphedema was defined as any hospital admission within 2 years for a diagnosis of lymphedema or related complications based on prior research.
This study demonstrates a 2.3% incidence of complicated lymphedema after breast cancer surgery. Increased health care utilization for these patients resulted in hospital charge accrual of more than $180 million in 2 years or approximately $140,000 per patient. Although limitations must be taken into consideration, the significant burden of lymphedema underscored here mandates further investigation into targeted, anticipatory management strategies for BCRL

Open access: No

Economic Benefits of BIS-Aided Assessment of post-BC Lymphedema in the United States.

Billr SP, DeKoven MP, Munakata J.

Economic analysis demonstrating that BIS utilization would lead to a cost savings which is magnified when considering sequelae of BCRL.
Over 1 year, BIS-aided assessment of lymphedema for patients following treatment for BC results in cost savings, even without considering potential cost savings associated with averted downstream sequelae.

Open access: Yes

Breast cancer-related lymphedema: comparing direct costs of a prospective surveillance model and a traditional model of care.

Stout, N.L., et al.

Early intervention may reduce the need for intensive rehabilitation and may be cost saving. This perspective article compares a prospective surveillance model with a traditional model of impairment-based care and examines direct treatment costs associated with
each program.
The prospective surveillance model includes the cost of screening all women plus the cost of intervention for early-stage BCRL. The TM group comprised women referred for BCRL treatment using a traditional model of referral based on late-stage lymphedema. The
traditional model cost includes the direct cost of treating patients with advancedstage lymphedema. The cost to manage early-stage BCRL per patient per year using a prospective surveillance model is $636.19. The cost to manage late-stage BCRL per patient per year using a traditional model is $3,124.92. The prospective surveillance model is emerging as the standard of care in breast cancer treatment and is a potential cost-saving mechanism for BCRL treatment.

Open access: Yes

Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: a 2-Year follow-up study.

Shih YC, Xu Y, Cormier JN, et al.

Claims study of 1,877 patients for 2 years after the start of cancer treatment. 10% of patients developed lymphedema with ALND and chemotherapy associated with development. Higher medical costs associated with BCRL diagnosis ($23, 167 vs. $14,877) with higher rates of cellulitis/lymphangitis noted.
Although the use of claims data may underestimate the true incidence of lymphedema, women with BCRL had a greater risk of infections and incurred higher medical costs. The substantial costs documented here suggest that further efforts should be made to elucidate reduction and prevention strategies for BCRL.

Open access: Yes


  1. Kilgore L, at al. Reducing breast cancer-related lymphedema (BCRL) through prospective surveillance monitoring using bioimpedance spectroscopy (BIS) and patient direction self-interventions. Ann Surg Oncol 2018;
  2. Ridner SH, et al. A Comparison of Bioimpedance Spectroscopy or Tape Measure Triggered Compression Intervention in Chronic Breast Cancer Lymphedema Prevention. Lymphatic Research and Biology 2022.