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 extended time period is warranted.
