Cancer Genetics and Epigenetics, 2025, Vol.13, No.6, 275-286 http://medscipublisher.com/index.php/cge 277 2023; Sharifi and Ahmad, 2024; Jahan et al., 2025). If this imbalance persists for a long time, it will lead to chronic swelling of the arm, tissue fibrosis, and more abnormalities in the morphology of the skin and blood vessels (Sharifi and Ahmad, 2024; Da Silva et al., 2025; Jahan et al., 2025). The latest research also found that some patients are inherently more prone to lymphedema. The characteristic of such patients is that the pressure of the basal lymph pump or the velocity of lymph fluid flow is relatively high. When the axillary area suffers injuries such as surgery, their lymphatic system is more likely to exceed the tolerance limit. Even if only a small number of lymph nodes are removed, it may develop into lymphedema (Kinney et al., 2023; Ma et al., 2025). 3 Evaluation Methods for Upper Limb Lymphedema 3.1 Traditional assessment: circumference/volume measurement and classification methods When checking whether there is lymphedema in the arms of patients after breast cancer surgery, the traditional and common method is to measure the thickness and size of the arms. There are two common methods: One is to measure the circumference at a fixed position on the arm with a flexible tape measure; Another approach is to calculate the arm volume through the water level change method or by using geometric formulas (such as the truncated cone formula). Generally speaking, if the circumference difference between the affected arm and the healthy arm reaches 2 centimeters or the volume difference exceeds 200 milliliters, it may be lymphedema. These inspection methods are not troublesome to carry out, cost little, and the results of repeated measurements are also relatively reliable. They are particularly suitable for use in routine clinical reexaminations and large-scale studies (Kageyama et al., 2025). The severity of lymphedema is usually classified based on the difference in circumference or volume, and the staging criteria of the International Society of Lymphology (ISL) are the most widely used. This standard classifies lymphedema into stage 0 (no obvious symptoms), stage I (can return to normal), stage II (partially cannot return to normal), and stage III (elephantiasis), and makes a judgment based on physical signs and symptoms described by the patient themselves (Kageyama et al., 2025). However, although these traditional methods are effective and easy to implement, they are difficult to detect early or asymptomatic lymphedema, and cannot reflect the changes in the structure and function of body tissues. 3.2 Emerging technologies: detection methods such as bioimpedance and ultrasound To make up for the shortcomings of traditional measurement methods, some new technologies are being used in the examination of lymphedema, which can provide more sensitive, objective and tissue-focused results. Bioimpedance spectroscopy (BIS) determines the accumulation of extracellular fluid by detecting changes in resistance, which enables early detection of lymphedema with mild symptoms and facilitates the tracking of treatment outcomes. Studies have shown that the results of BIS have a high correlation with volume measurement results. Moreover, it is non-invasive and simple to operate, and is gradually becoming a commonly used method in clinical practice and research. Ultrasound examination can clearly observe the thickness changes of the skin, subcutaneous tissue and muscle, and can also detect abnormal echoes caused by lymphedema. High-frequency ultrasound is particularly suitable for detecting early tissue changes. Even if the arm does not show obvious swelling from the outside, it can still help doctors determine the stage of the disease and provide an accurate diagnosis. In addition, ultrasound can also assist in preoperative assessment, guide treatment, and observe changes after treatment (Aydinn et al., 2025). Other advanced methods, such as tissue dielectric constant (TDC) measurement and three-dimensional laser scanning, can also rapidly, non-invasively and stably assess the fluid content and volume of the arm. 3.3 Function and quality of life assessment A comprehensive assessment of upper limb lymphedema should not only focus on appearance and volume measurement, but also pay attention to the patient's activity limitation and quality of life (QoL). Commonly used patient self-assessment tools (PROMs) include the DASH scale, LULL -27, lymphoi-icf-ul, LYMQOL, etc. These tools can help understand the impact of lymphedema on patients' daily activities, psychological state and social
RkJQdWJsaXNoZXIy MjQ4ODYzNA==