Measurement of upper extremity volume in women after axillary dissection for breast cancer

Megens AM, Harris SR, Kim-Sing C, McKenzie DC. Measurement of upper extremity volume in women after axillary dissection for breast cancer. Arch Phys Med Rehabil 2001;82:1639-44. Objective: To determine if 2 methods of calculating upper extremity volume (using arm circumferences) can substitute for water displacement volumetry. Design: Interrater and test-retest reliability and limits of agreement for volume measures. Setting: University. Participants: Twenty-five women at risk for lymphedema who had undergone axillary lymph node dissection surgery for breast cancer. Interventions: Circumference and volume measurements of both upper extremities were taken by 2 physical therapists at an initial visit and by 1 of the therapists 1 week later. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated to analyze measurement reliability. Pearson's product-moment correlation coefficient (r) was used to evaluate the relationship between volumetry and calculated truncated cone volumes. Limits of agreement were calculated to determine the level of agreement between the 2 measurement methods. Results: Interrater and test-retest reliability ICCs for circumferential and volumetric data were .99 and .99, respectively. Pearson's r values were .93 and .97 for the single truncated cone and the summed truncated cone volume calculations, respectively. Limits of agreement (mean ± 2 standard deviations) were −52 ± 334mL and −40 ± 234mL, respectively, between volumetry and the single truncated cone and summed truncated cone calculations. Conclusions: Calculated and volumetric measurements in this population are both reliable and closely related, but do not agree with each another, and thus should not be used interchangeably. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation