Can a practicing surgeon detect early lymphedema reliably?
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.
Department of Surgery, School of Medicine, Wayne State University, Detroit, MI, USA.
Keiva L
KL
Bland
Rebecca
R
Perczyk
Wei
W
Du
Christine
C
Rymal
Prathima
P
Koppolu
Ruthie
R
McCrary
Kathryn A
KA
Carolin
Mary Ann
MA
Kosir
D001132:Arm / Q000033:anatomy & histology; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012680:Sensitivity and Specificity; D013997:Time Factors