Lymphoedema measurement methods in cancer survivors: accuracy, health economics and practice implications.

BACKGROUND

Lymphoedema assessment is central to diagnosis and management, but the optimal method remains uncertain. Tape measurement is widely used, although newer technologies may improve efficiency and patient experience.

AIMS: To compare five assessment methods for diagnostic accuracy, time-efficiency, cost and acceptability.

METHODS

Eighty-four adults with unilateral cancer-related lymphoedema underwent tape measurement, Perometer, L-Dex®, Bodystat Quadscan, and self-report. Analyses included reliability (Cronbach's alpha, Pearson's correlation), diagnostic accuracy and a health economic evaluation.

FINDINGS: Tape measurement at a 7.5% threshold achieved the highest accuracy (sensitivity 94%, specificity 95%). The Perometer was fastest and most favoured by participants, but was costly. Bio-impedance methods had moderate diagnostic value, particularly for early detection.

CONCLUSION

The tape measure remains the most practical standard tool, while the Perometer offers efficiency and patient appeal where resources permit.