Lymphedema may affect the breast as well as the ipsilateral arm in a woman with breast cancer. Degnim et al measured skin thickness using ultrasonography to identify breast lymphedema. The authors are from the Mayo Clinic in Rochester, Minnesota.


Technique: skin thickness was measured at the 6 o'clock position in both breasts using ultrasonography



(1) skin thickness in mm on the side with breast cancer

(2) skin thickness in mm on the opposite side


ratio of skin thicknesses =

= (skin thickness in mm on the affected side) / (skin thickness in mm on the unaffected side)


Criteria for lymphedema:

(1) skin thickness on the affected side >= 3.2 mm

(2) ratio of skin thicknesses >= 1.32



• The sensitivity of the skin thickness was 78%, the specificity 92% and area under the ROC curve 0.82.

• The sensitivity of the ratios of skin thickness was 81%, the specificity 82% and area under the ROC curve 0.86.



• The ratio may not work if the woman has bilateral breast disease.

• The measurements may not work in a woman with scleroderma or other infiltrative skin disease.


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