Table 1.

Summary of the various methods used to define, measure, quantify, and manage lymphedema following treatment for breast cancer, as well as the appropriate timing of assessment.

Topic	Details	References
Definition	Circumferential Difference	1.0 – 3.0 cm	Tsai 2009 [46], Wernicke 2011 [48]
	Volume Difference	200 ml	Boccardo 2009 [16], Tsai 2009 [46]
	Percent Difference	3 – 20%	Armer 2009 [7], Tsai 2009 [46], Stout Gergich 2008 [49]
	Self-Report		Armer 2010 [6], Norman 2009 [62]
Measurement	Tape Measurement	Arm circumference	Deltombe 2007 [10], Jain 2010 [53]
	Water Displacement	Volume	Deltombe 2007 [10], Tewari 2008 [54], Smoot 2011 [55], Fu 2009 [56], Ridner 2007 [57]
	Bioimpedance Spectroscopy	Impedance value	Smoot 2011 [55], Ward 2011 [58], Ridner 2009 [59]
	Perometry	Volume	Jain 2010 [53], Stanton 1997 [60], Petlund 1991 [61]
	Self-Report		McLaughlin 2008 [4], Norman 2009 [62], Czerniec 2010 [63]
Quantification	Absolute Volume Difference	ml or cm difference	McLaughlin 2008 [4], Ashikaga 2010 [5], Tsai 2009 [46], Wernicke 2011 [48]
	Relative Volume Difference	Percent difference between arms	Ancukiewicz 2012 [64]
	Relative Volume Change (RVC)	Percent change between arms as compared to baseline	Ancukiewicz 2012 [64], Ancukiewicz 2011 [65]
Timing	Pre-operative Arm Volume Measurements	Accounts for any normal asymmetry between arms	Armer 2010 [6], Stout Gergich 2008 [49], Ancukiewicz 2011 [65], Harris 2001 [66], NLN Position Paper 2011 [67]
	Continuous Post-operative Screening	Prospective surveillance may allow for early detection and treatment, but has not been fully evaluated for its application, cost and outcome	NLN Position Paper 2012 [79], Cheville 2012 [80], Stout 2011 [81]
Management	Complex Decongestive Therapy (CDT)	Recommended and considered effective; lacks Level 1 evidence to support its use; further study needed to determine efficacy as stand-alone treatment	Vignes 2011 [70], Forner-Cordero 2009 [71], Lasinski 2012 [72]
	Manual Lymphatic Drainage	No signficant impact on edema development when compared to exercise and precautionary advice	Devoogdt 2011 [73]
	Compression Sleeve without CDT	Assessed in a small cohort study without randomization; further study needed	Stout Gergich 2008 [49], Partsch 2010 [74]
	Pneumatic Compression	No robust evidence about long-term outcomes	Fife 2012 [75], Wilburn 2006 [76]
	Low-Level Laser Treatment	Lacks data to support its use	Omar 2012 [77]