LymphedemaV1, Main, Exploration, bibRecord, 004950

Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology

Identifieur interne : 004950 ( Main/Exploration ); précédent : 004949; suivant : 004951

Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology

Auteurs : Marek Ancukiewicz [États-Unis] ; Cynthia L. Miller [États-Unis] ; Melissa N. Skolny [États-Unis] ; Jean O'Toole [États-Unis] ; Laura E. Warren [États-Unis] ; Lauren S. Jammallo [États-Unis] ; Michelle C. Specht [États-Unis] ; Atphonse G. Taghian [États-Unis]

Source :

Breast cancer research and treatment [ 0167-6806 ] ; 2012.

RBID : Pascal:12-0342213

Descripteurs français

KwdFr :
- Bras (anatomopathologie), Complications postopératoires, Femelle, Humains, Indice de masse corporelle, Lymphoedème (anatomopathologie), Lymphoedème (étiologie), Qualité de vie, Tumeurs du sein ().
MESH :
- anatomopathologie : Bras, Lymphoedème.
- étiologie : Lymphoedème.
Pascal (Inist)
- Complications postopératoires, Etude comparative, Bras, Femelle, Humains, Indice de masse corporelle, Qualité de vie, Taille, Analyse quantitative, Cancer du sein, Lymphoedème, Méthodologie, Qualité de vie, Tumeurs du sein.
Wicri :
- topic : Analyse quantitative.

English descriptors

KwdEn :
- Arm, Arm (pathology), Body Mass Index, Breast Neoplasms (surgery), Breast cancer, Comparative study, Female, Humans, Lymphedema, Lymphedema (etiology), Lymphedema (pathology), Methodology, Postoperative Complications, Quality of Life, Quality of life, Quantitative analysis, Size.
MESH :
- etiology : Lymphedema.
- pathology : Arm, Lymphedema.
- surgery : Breast Neoplasms.
- Body Mass Index, Female, Humans, Postoperative Complications, Quality of Life.

Abstract

The purpose of this article is to evaluate arm measurements of breast cancer patients to critically assess absolute change in arm size compared to relative arm volume change as criteria for quantifying breast cancer-related lymphedema (BCRL). We used pre-operative measurements of 677 patients screened for BCRL before and following treatment of unilateral breast cancer at Massachusetts General Hospital between 2005 and 2008 to model the effect of an absolute change in arm size of 200 mL or 2 cm compared to relative arm volume change. We also used sequential measurements to analyze temporal variation in unaffected arm volume. Pre-operative arm volumes ranged from 1,270 to 6,873 mL and correlated strongly (Kendall's τ = 0.55) with body mass index (BMI). An absolute arm volume change of 200 mL corresponded to relative arm volume changes ranging from 2.9 to 15.7 %. In a subset of 45 patients, modeling of a 2-cm change in arm circumference predicted relative arm volume changes ranging from 6.0 to 9.8 %. Sequential measurements of 124 patients with >6 measurements demonstrated remarkable temporal variation in unaffected arm volume (median within-patient change 10.5 %). The magnitude of such fluctuations correlated (_T = 0.36, P < 0.0001) with pre-operative arm volume, patient weight, and BMI when quantified as absolute volume change, but was independent of these variables when quantified as relative arm volume change (P > .05). Absolute changes in arm size used as criteria for BCRL are correlated with pre-operative and temporal changes in body size. Therefore, utilization of absolute volume or circumference change in clinical trials is flawed because specificity depends strongly on patient body size. Relative arm volume change is independent of body size and should thus be used as the standard criterion for diagnosis of BCRL.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564235

Affiliations:

Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm</term>
<term>Arm (pathology)</term>
<term>Body Mass Index</term>
<term>Breast Neoplasms (surgery)</term>
<term>Breast cancer</term>
<term>Comparative study</term>
<term>Female</term>
<term>Humans</term>
<term>Lymphedema</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (pathology)</term>
<term>Methodology</term>
<term>Postoperative Complications</term>
<term>Quality of Life</term>
<term>Quality of life</term>
<term>Quantitative analysis</term>
<term>Size</term>
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<term>Complications postopératoires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Lymphoedème (étiologie)</term>
<term>Qualité de vie</term>
<term>Tumeurs du sein ()</term>
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<term>Lymphoedème</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Arm</term>
<term>Lymphedema</term>
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<term>Humans</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Complications postopératoires</term>
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<term>Femelle</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Qualité de vie</term>
<term>Taille</term>
<term>Analyse quantitative</term>
<term>Cancer du sein</term>
<term>Lymphoedème</term>
<term>Méthodologie</term>
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<front><div type="abstract" xml:lang="en">The purpose of this article is to evaluate arm measurements of breast cancer patients to critically assess absolute change in arm size compared to relative arm volume change as criteria for quantifying breast cancer-related lymphedema (BCRL). We used pre-operative measurements of 677 patients screened for BCRL before and following treatment of unilateral breast cancer at Massachusetts General Hospital between 2005 and 2008 to model the effect of an absolute change in arm size of 200 mL or 2 cm compared to relative arm volume change. We also used sequential measurements to analyze temporal variation in unaffected arm volume. Pre-operative arm volumes ranged from 1,270 to 6,873 mL and correlated strongly (Kendall's τ = 0.55) with body mass index (BMI). An absolute arm volume change of 200 mL corresponded to relative arm volume changes ranging from 2.9 to 15.7 %. In a subset of 45 patients, modeling of a 2-cm change in arm circumference predicted relative arm volume changes ranging from 6.0 to 9.8 %. Sequential measurements of 124 patients with >6 measurements demonstrated remarkable temporal variation in unaffected arm volume (median within-patient change 10.5 %). The magnitude of such fluctuations correlated (<sub>T</sub>
 = 0.36, P < 0.0001) with pre-operative arm volume, patient weight, and BMI when quantified as absolute volume change, but was independent of these variables when quantified as relative arm volume change (P > .05). Absolute changes in arm size used as criteria for BCRL are correlated with pre-operative and temporal changes in body size. Therefore, utilization of absolute volume or circumference change in clinical trials is flawed because specificity depends strongly on patient body size. Relative arm volume change is independent of body size and should thus be used as the standard criterion for diagnosis of BCRL.</div>
</front>
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<affiliations><list><country><li>États-Unis</li>
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</region>
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<tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Ancukiewicz, Marek" sort="Ancukiewicz, Marek" uniqKey="Ancukiewicz M" first="Marek" last="Ancukiewicz">Marek Ancukiewicz</name>
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<name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S." last="Jammallo">Lauren S. Jammallo</name>
<name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L." last="Miller">Cynthia L. Miller</name>
<name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name>
<name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N." last="Skolny">Melissa N. Skolny</name>
<name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C." last="Specht">Michelle C. Specht</name>
<name sortKey="Taghian, Atphonse G" sort="Taghian, Atphonse G" uniqKey="Taghian A" first="Atphonse G." last="Taghian">Atphonse G. Taghian</name>
<name sortKey="Warren, Laura E" sort="Warren, Laura E" uniqKey="Warren L" first="Laura E." last="Warren">Laura E. Warren</name>
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Serveur d'exploration sur le lymphœdème

Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology

Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology

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	Serveur d'exploration sur le lymphœdème
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