title: Comparison of diagnostic accuracy of clinical measures of breast cancer-related lymphedema: area under the curve.
abstract: OBJECTIVE
  To compare diagnostic accuracy of measures of breast cancer-related lymphedema (BCRL).
  
  
  METHODS
  Cross-sectional design comparing clinical measures with the criterion standard of previous diagnosis of BCRL.
  
  
  METHODS
  University of California San Francisco Translational Science Clinical Research Center.
  
  
  METHODS
  Women older than 18 years and more than 6 months posttreatment for breast cancer (n=141; 70 with BCRL, 71 without BCRL).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Sensitivity, specificity, receiver operator characteristic curve, and area under the curve (AUC) were used to evaluate accuracy.
  
  
  RESULTS
  A total of 141 women were categorized as having (n=70) or not having (n=71) BCRL based on past diagnosis by a health care provider, which was used as the reference standard. Analyses of ROC curves for the continuous outcomes yielded AUC of .68 to .88 (P<.001); of the physical measures bioimpedance spectroscopy yielded the highest accuracy with an AUC of .88 (95% confidence interval, .80-.96) for women whose dominant arm was the affected arm. The lowest accuracy was found using the 2-cm diagnostic cutoff score to identify previously diagnosed BCRL (AUC, .54-.65).
  
  
  CONCLUSIONS
  Our findings support the use of bioimpedance spectroscopy in the assessment of existing BCRL. Refining diagnostic cutoff values may improve accuracy of diagnosis and warrant further investigation.
authors: Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, 94143-0736, USA. betty.smoot@ucsf.edu
authors: Betty J
authors: BJ
authors: Smoot
authors: Josephine F
authors: JF
authors: Wong
authors: Marylin J
authors: MJ
authors: Dodd
mesh_terms: D019540:Area Under Curve; D001943:Breast Neoplasms / Q000628:therapy*; D003430:Cross-Sectional Studies; D058266:Dielectric Spectroscopy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology*; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity