Breast cancer-related lymphedema diagnostic agreement moderate at best for commonly used diagnostic criteria<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b>
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THURSDAY, April 24, 2025 (HealthDay News) — Different measurement tools and diagnostic criteria show low-to-moderate agreement for diagnosing breast cancer-related lymphedema (BCRL), according to a study published in the April issue of Rehabilitation Oncology<\/em>.<\/p>\n Cheryl L. Brunelle, P.T., from Massachusetts General Hospital in Boston, and colleagues examined diagnostic agreement among commonly utilized diagnostic thresholds for BCRL among 60 patients measured using four methods: tape measure (every 4 cm [Q4] and National Lymphedema Network [NLN] methods) converted to volume, optoelectronic limb volumetry, and bioimpedance spectroscopy (BIS). Relative volume change (RVC) \u226510 percent, absolute volume difference \u226510 percent, and L-Dex scores >6.5 or >10 with and without preoperative baseline were compared as diagnostic thresholds.<\/p>\n Data were analyzed from 57 participants; 36.8 percent were diagnosed with BCRL (RVC \u226510 percent). The researchers found that when BCRL diagnosis included preoperative baseline, poor and insignificant diagnostic agreement was seen between RVC \u226510 percent and L-Dex increase \u22656.5 (Cohen’s kappa, \u22120.083). Fair diagnostic agreement was seen between diagnosis made with versus without incorporation of preoperative baseline measurement (with preoperative baseline RVC and BIS: Cohen’s kappa, 0.233; without preoperative baseline NLN, Q4, volumeter, or BIS without baseline: Cohen’s kappa, 0.308); moderate agreement was seen for diagnosis via RVC versus volumeter (Cohen’s kappa, 0.531). No diagnostic agreement was seen between L-Dex increase \u22656.5 from baseline and measures without preoperative baseline (NLN, Q4, and volumeter) for the 21 patients with BIS baseline.<\/p>\n “Our findings highlight the unacceptably low levels of agreement between different tests for recognizing this complication, and the urgent need to establish standardized diagnostic criteria,” Brunelle said in a statement.<\/p>\n