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BioMed Research International
Volume 2013 (2013), Article ID 807569, 8 pages
Research Article

Comparison of Breast Cancer-Related Lymphedema (Upper Limb Swelling) Prevalence Estimated Using Objective and Subjective Criteria and Relationship with Quality of Life

1School of Health Sciences, Queen Margaret University, Edinburgh, Queen Margaret University Drive, Musselburgh, East Lothian EH21 6UU, UK
2Breast Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK

Received 9 April 2013; Accepted 30 May 2013

Academic Editor: Hirotaka Iwase

Copyright © 2013 Catherine Bulley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95–10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema.