A Comparison of Four Diagnostic Criteria for Lymphedema in a Post-Breast Cancer Population

作者：Jane M. Armer, Bob R. Stewart · 发表于：Lymphatic Research and Biology · 年份：2005 · DOI：10.1089/lrb.2005.3.208 · 被引用次数：361 · 研究领域：Lymphatic System and Diseases、Lymphatic Disorders and Treatments、Diagnosis and Treatment of Venous Diseases

BACKGROUND: Breast cancer survivors are at life-time risk of developing lymphedema (LE). The goal of this research was to describe LE incidence over time among women treated for breast cancer. METHODS AND RESULTS: Limb volume changes (LVC) were evaluated by two measurement methods, circumferences and perometry, among 118 participants followed preoperative to 12 months postdiagnosis. Four diagnostic criteria were used: 200 mL perometry LVC; 10% perometry LVC; 2 cm circumferential increase; and report of heaviness or swelling, either "now" or "in the past year." Using 200 mL, the estimated LE rate was 24% (95% CI = 17%-32%) at 6 months, and 42% (31%-53%) at 1 year. Using 10% LVC, the estimated LE rate was 8% (2%-13%) at 6 months, and 21% (12%-30%) at 1 year. Using 2 cm, the estimated LE rate was 46% (36%-56%) at 6 months, and 70% (60%-79%) at 1 year. Based on reported symptoms of heaviness or swelling, the estimated LE rate was 19% (11%-26%) at 6 months, and 40% (30-59%) at 1 year. CONCLUSIONS: In the absence of a gold standard, we can only say that the different LE definitions are not equivalent, but cannot say which is "best". From this data, it appears that 10% LVC corresponds to a more conservative definition, whereas the 2 cm difference corresponds to a more liberal definition. These preliminary findings also document the importance of baseline (preoperative) anthropometric and symptom data and monitoring of changes over time. Further investigation of LE occurrence over an...