Comparative Analysis of Ultrasound and Thermography for Detecting Tissue Alterations in Breast Cancer-related Lymphedema

Aims: To associate the results of thermography and ultrasound of the upper limb with lymphedema in women after breast cancer.

Study Design: Cross-sectional study.

Place and Duration of Study: Conducted in Recife, Brazil, from September 2022 to July 2024.

Methodology: A total of 43 breast cancer survivors were included. Each participant underwent frontal thermography using a Thermovision FLIR Systems C5 camera. Minimum, mean, and maximum temperatures were evaluated at specific points on the forearm (TA) and arm (TB) using the FLIR Tools software. The same points were analyzed using ultrasound to identify fibrosis, fat infiltration, thickening of the dermo epidermal layer (DEC), and loss of differentiation between layers. Statistical analysis was performed using JASP software.

Results: The study identified a higher prevalence of DEC thickening in the arm (68.5%) and forearm (57.9%). However, no significant correlation was observed between skin temperature and tissue alterations (P > .05), with a small effect size and limited clinical relevance

Conclusion:
The study revealed a significant prevalence of fibrosis and dermoepidermal layer thickening in lymphedema-affected upper limbs, with higher relative risk observed in participants with lymphedema. Thermographic analysis, however, did not show significant temperature differences correlating with ultrasound findings, highlighting its limited standalone diagnostic value.