Armer Jane M, Stewart Bob R, Shook Robin P
Jane M Armer, Professor, Sinclair School of Nursing (SSON), Director, Nursing Research, Ellis Fischel Cancer Center; Bob R Stewart, Professor Emeritus, College of Education, Adjunct Clinical Professor, SSON; Robin P Shook, Project Development Specialist, Lymphedema Research Project, SSON, University of Missouri, Columbia, USA.
J Lymphoedema. 2009 Apr 1;4(1):14-18.
Quantification of lymphoedema (LE) has been problematic, and the reported incidence of LE varies greatly among women treated with surgery and radiation for breast cancer. AIMS: This study aims to describe LE occurrence over time among breast cancer survivors using four diagnostic criteria based on three measurement techniques. METHODS: Limb volume and symptom assessment data were followed after surgery every three months for 12 months, then every six months for 30 months. Limb volume changes (LVC) were measured by circumferences and by perometry, and by symptom experience via interview. Standard survival analysis methods identified when the criteria indicating LE were met. RESULTS: Trends in LE occurrence are reported for data from 211 participants. At 30 months post-treatment, LE incidence ranged from 41-91%, with 2cm being the highest estimation method and self-reported signs and symtoms (SS) the lowest. CONCLUSIONS: This 30-month analysis supports the previous 12-month analysis in finding the 2cm criteria as the most liberal definition of LE. Self-reporting of heaviness and swelling, along with 10% LVC, represented the most conservative definitions (41% and 45%, respectively).
淋巴水肿（LE）的量化一直存在问题，在接受乳腺癌手术和放疗的女性中，报道的LE发病率差异很大。
本研究旨在使用基于三种测量技术的四种诊断标准，描述乳腺癌幸存者中LE随时间的发生情况。
术后每三个月随访一次肢体体积和症状评估数据，共12个月，然后每六个月随访一次，共30个月。通过周长和体积测量法测量肢体体积变化（LVC），并通过访谈了解症状体验。采用标准生存分析方法确定符合LE标准的时间。
报告了211名参与者数据的LE发生趋势。治疗后30个月，LE发病率在41%-91%之间，以2厘米为标准的估计方法发病率最高，自我报告的体征和症状（SS）发病率最低。
这项为期30个月的分析支持了之前为期12个月的分析，即发现以2厘米为标准是对LE最宽松的定义。自我报告的沉重感和肿胀感，以及10%的LVC，是最保守的定义（分别为41%和45%）。
