BACKGROUND: Understanding normal volume asymmetry is essential for accurate assessment of limb volume changes following breast cancer (BC) treatment in which lymphatic function is disrupted. The purposes of this study were to evaluate for differences in dominant and nondominant limb volumes and to evaluate for interactions between the effects of dominance and side of cancer on limb volume. METHODS AND RESULTS: This study evaluated preoperative limb volumes of 397 women enrolled in a prospective, longitudinal study of neuropathic pain and lymphedema. Volume was calculated from circumference. Limb resistance was measured with bioimpedance. Women were dichotomized into two groups: those whose cancer was on their dominant side and those whose cancer was on their nondominant side. Analyses of variance were used to evaluate for differences. In 47%, BC occurred on the side of the dominant limb. Except for the 30 to 40 centimeter (cm) limb volume segment, a main effect of dominance was found for all measures. The volume of the dominant limb was significantly greater than that of the nondominant limb. No main effects were found for side of cancer. A statistically significant interaction was found only at the 0 to 10 cm limb volume segment. CONCLUSIONS: Prior to BC treatment, the dominant limb demonstrated lower bioimpedance resistance (-2.09%) and greater total limb volume (1.12%) than the nondominant limb. Segmental volume differences were greatest at the proximal forearm segment (2.31%) and least at the proximal arm segment (0.21%). This study provides evidence that preoperative volume assessment is important due to normal variability associated with limb dominance.
BACKGROUND: Understanding normal volume asymmetry is essential for accurate assessment of limb volume changes following breast cancer (BC) treatment in which lymphatic function is disrupted. The purposes of this study were to evaluate for differences in dominant and nondominant limb volumes and to evaluate for interactions between the effects of dominance and side of cancer on limb volume. METHODS AND RESULTS: This study evaluated preoperative limb volumes of 397 women enrolled in a prospective, longitudinal study of neuropathic pain and lymphedema. Volume was calculated from circumference. Limb resistance was measured with bioimpedance. Women were dichotomized into two groups: those whose cancer was on their dominant side and those whose cancer was on their nondominant side. Analyses of variance were used to evaluate for differences. In 47%, BC occurred on the side of the dominant limb. Except for the 30 to 40 centimeter (cm) limb volume segment, a main effect of dominance was found for all measures. The volume of the dominant limb was significantly greater than that of the nondominant limb. No main effects were found for side of cancer. A statistically significant interaction was found only at the 0 to 10 cm limb volume segment. CONCLUSIONS: Prior to BC treatment, the dominant limb demonstrated lower bioimpedance resistance (-2.09%) and greater total limb volume (1.12%) than the nondominant limb. Segmental volume differences were greatest at the proximal forearm segment (2.31%) and least at the proximal arm segment (0.21%). This study provides evidence that preoperative volume assessment is important due to normal variability associated with limb dominance.
Authors: Maria Kyranou; Steven M Paul; Laura B Dunn; Kathleen Puntillo; Bradley E Aouizerat; Gary Abrams; Deborah Hamolsky; Claudia West; John Neuhaus; Bruce Cooper; Christine Miaskowski Journal: Eur J Oncol Nurs Date: 2012-08-11 Impact factor: 2.398
Authors: Marek Ancukiewicz; Cynthia L Miller; Melissa N Skolny; Jean O'Toole; Laura E Warren; Lauren S Jammallo; Michelle C Specht; Alphonse G Taghian Journal: Breast Cancer Res Treat Date: 2012-06-19 Impact factor: 4.872
Authors: Nicole L Stout; Lucinda A Pfalzer; Ellen Levy; Charles McGarvey; Barbara Springer; Lynn H Gerber; Peter Soballe Journal: PM R Date: 2011-10-05 Impact factor: 2.298
Authors: Christina Van Onselen; Bradley E Aouizerat; Laura B Dunn; Steven M Paul; Claudia West; Deborah Hamolsky; Kathryn Lee; Michelle Melisko; John Neuhaus; Christine Miaskowski Journal: Breast Date: 2012-08-01 Impact factor: 4.380
Authors: Christine Miaskowski; Bruce Cooper; Steven M Paul; Claudia West; Dale Langford; Jon D Levine; Gary Abrams; Deborah Hamolsky; Laura Dunn; Marylin Dodd; John Neuhaus; Christina Baggott; Anand Dhruva; Brian Schmidt; Janine Cataldo; John Merriman; Bradley E Aouizerat Journal: J Pain Date: 2012-12 Impact factor: 5.820
Authors: Christine Miaskowski; Marylin Dodd; Steven M Paul; Claudia West; Deborah Hamolsky; Gary Abrams; Bruce A Cooper; Charles Elboim; John Neuhaus; Brian L Schmidt; Betty Smoot; Bradley E Aouizerat Journal: PLoS One Date: 2013-04-16 Impact factor: 3.240