Circumference-Based Criteria for Detection of Secondary Arm Lymphedema for Chinese Women

Hewei Wang,  Li Shen, Tao Liu, Peng Shao, Elizabeth S. Dylke, Jie Jia, and Sharon L. Kilbreath. Lymphatic Research and Biology, 2017

Background: Detection of upper limb lymphedema following treatment for breast cancer typically relies on interlimb circumference-based differences. Normative-determined criteria from an Australian population have high sensitivity and specificity for detection of mild lymphedema in Australian women. It is unknown whether these criteria are applicable to Chinese women whose body habitus is different from Australian women. The aims of this study, therefore, were to determine the normative-based interlimb circumference and volume differences in a Chinese population and whether specific population-based thresholds are required.

Methods and Results: Arm circumferences at the wrist and at 10cm intervals proximally to 40cm were measured on both the dominant and nondominant limb in 484 healthy women, aged ‡20 years. Absolute interlimb differences and interlimb ratios were determined for the circumferences and derived 10cm volume segments. Analysis of variance determined if the differences varied, depending on location. The absolute interlimb circumference difference from 10 to 30cm did not vary significantly, enabling determination of a single threshold applicable to all three circumferences. The interlimb ratios varied less, requiring only a threshold for the wrist and one for 10–40cm and one ratio for interlimb volume segments. The interlimb thresholds determined in the Chinese population were within 2mm to that reported in the Australian study.

Conclusions: Even though the habitus of Chinese women living in China differed to the women living in Australia, similar normative-based thresholds for the detection of lymphedema were identified