Background: Lymphedema may be identified by simpler circumference changes as compared with changes in limb volume.

Methods: Ninety breast cancer patients were prospectively enrolled in an academic trial, and seven upper extremity circumferences were measured quarterly for 3 years. A 10% volume increase or greater than 1 cm increase in arm circumference identified lymphedema with verification by a lymphedema specialist. Sensitivity and specificity of several different criteria for detecting lymphedema were compared using the academic trial as the standard.

Results: Thirty-nine cases of lymphedema were identified by the academic trial. Using a 10% increase in circumference at two sites as the criterion, half the lymphedema cases were detected (sensitivity 37%). When using a 10% increase in circumference at any site, 74.4% of cases were detected (sensitivity 49%). Detection by a 5% increase in circumference at any site was 91% sensitive.

Conclusions: An increase of 5% in circumference measurements identified the most potential lymphedema cases compared with an academic trial.

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http://dx.doi.org/10.1016/j.amjsurg.2003.07.003DOI Listing

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