Project Coversheet

Date of Award


Degree Type

DNP Project

Degree Name

Doctor of Nursing (ND)




Hector R. Morales, DNP, APRN, PMH-CNS-BC


The purpose of this quality improvement project was to implement the standardized use of Bioimpedance Spectroscopy (BIS) for the early detection and management of breast cancerrelated lymphedema (BCRL). BCRL is a common complication of breast cancer treatments resulting from damage to the lymphatic system. While three of every four patients that develop lymphedema typically do so within the first three years after treatment, this complication can develop at any time during or after therapeutic intervention. The National Comprehensive Cancer Network® Clinical Practice Guidelines and others suggest that bilateral baseline limb measurements should be performed on patients at high risk for developing post-treatment BCRL. Early detection and diagnosis of lymphedema are critical for its optimal management because while stages 0 and 1 are reversible, stages 2 and 3 are typically less responsive to treatment. Subclinical BCRL can be detected using BIS before, during, and after surgical procedures and chemoradiation therapy. Furthermore, this procedure can be repeated at regular intervals to monitor lymphedema. This QI project identified changes and improvements in which the use of BIS resulted in superior outcomes for breast cancer patients. One hundred and thirty-one charts were reviewed, and five participants were included in the QI project. The types of breast cancer ranged from Stage 1A, invasive ductal carcinoma (IDCA), hormone receptor positive, sentinel axillary lymph node biopsy (SLNB), axillary lymph node dissection (ALND), Stage 3B, and Stage 3A, triple negative receptor. BIS is an important modality that can be used to evaluate the effectiveness of clinical interventions and to manage pivotal outcomes in patients with BCRL.

Included in

Nursing Commons