Serial interval assessment of limb volume segments may be an important clinical tool to detect early-onset lymphedema in patients with breast cancer before total limb volume (TLV) changes, say authors of an article published online October 5 in PM&R. At arm segments 10-20 cm and 20-30 cm, a significant volume increase was noted before the diagnosis of subclinical breast cancer–related lymphedema (BCRL). Segmental volume changes correlated to the TLV change. At segments 20-30 cm, the coefficient of determination was r2 = 0.952, and at 10-20 cm it was r2 = 0.845, suggesting that these segments predicted TLV changes, add the authors.
A total of 196 patients were enrolled in this prospective study conducted in a military hospital outpatient breast care center. Subclinical lymphedema developed in 46 of the patients. Limb volume data were available for 45 of the 46 patients from visits before the onset of lymphedema and were used in the analysis. The authors compared this group with an age-matched control group without BCRL from the same cohort (n = 45).
Women were enrolled and assessed preoperatively. Baseline measures of limb volume were obtained with the use of optoelectronic perometry, and reassessment was conducted at 1, 3, 6, 9, and 12 months postoperatively. BCRL was identified in 46 of 196 women at an average of 6.9 months postoperatively. A retrospective analysis was conducted in which the authors examined volume changes over 4 10-cm segments of the limb at the visits before the onset of BCRL. By using repeated-measures multivariate analysis of variance, the authors compared segmental volumes between groups at preoperative baseline, time of diagnosis of BCRL, and time of follow-up after early intervention. Linear regression analysis was performed to determine the strength of the relationship between total limb volume change with segmental volumes at the time of diagnosis of BCRL.
APTA Board of Directors member Nicole Stout, PT, MPT, CLT-LANA, led the study, which was coauthored by APTA members Lucinda A Pfalzer, PT, MA, PhD, FACSM, FAPTA, Charles McGarvey, PT, DPT, MS, FAPTA, and Barbara Springer, PT, PhD, OCS, SCS.