Center for Breast Care

Lymphedema is the swelling of an area within your lymphatic system that can develop following some treatments of breast cancer. To manage the condition if and when it develops, Lexington Clinic’s Center for Breast Care offers lymphedema screenings and treatments as part of its Lymphedema Prevention Program. Lymphedema Prevention Program  The Lymphedema Prevention Program is designed to reduce your risk of getting life-long lymphedema by testing you for early stages of lymphedema with the goal of preventing it from getting worse. The SOZO® device, which measures the fluid status and tissue composition in the arms and legs, provides a score called L-Dex®. The L-Dex score is used to track changes in one extremity over time. This device is noninvasive and painless.          

Lymphedema: FAQs

What is the lymphatic system? The lymphatic (“lim-fatic”) system is the waste removal system in your body. It removes waste material from your cells and tissues, including proteins, infections, viruses, cancer cells and anything foreign like perfumes and dyes. An important trait of the system is its location within the skin, specifically the second layer called the dermis. Lymph fluid collects in clusters of lymph nodes found throughout the body in the neck, underarm, groin, stomach and tailbone region. What is lymphedema? When fluid backs up in your lymphatic system and causes an area to swell, it is called lymphedema. Lymphedema can be very mild, moderate or severe. Fluid in lymphedema has been present for more than 64 days, unlike that of regular edema (or swelling). For example, the swelling from a sprained ankle is not lymphedema. What causes lymphedema? In the United States, treatment from breast cancer, which may involve the removal of lymph nodes and radiation therapy, is the leading cause of lymphedema. The likelihood of developing lymphedema increases with the amount of breast tissue removed, the number of lymph nodes removed, and the amount and extent of radiation treatments. Other factors that increase the risk of lymphedema include obesity, lack of exercise and previous cancer complications. Water retention does not cause lymphedema. Breast Cancer Treatments That Increase Risk of Lymphedema: • Axillary lymph node dissection • Axillary radiation • Mastectomy • Sentinel lymph node biopsy What are the signs of lymphedema? The most common sign of lymphedema after breast cancer treatment is a heaviness or weighted feeling to the affected arm. Some patients may notice a color or temperature change in the arm. The arm may also be painful or achy. Common Signs of Lymphedema After Breast Cancer Treatment • Swelling in the arm, hand, and/or fingers on the same side as surgery or radiation • A feeling of heaviness or tightness in the arm or hand • Tightening of clothing, rings, watches, or bracelets When does lymphedema develop? Lymphedema usually develops within 24 months after surgery or cancer treatment. However, in some cases a small incident can stimulate lymphedema several years after surgery or treatment. Again, the swelling from breast surgery is not considered lymphedema until it is persistent and not improving over time. When will lymphedema go away? Unfortunately, the lymphatic system does not have the ability to repair itself. Once an area has been damaged from surgery, radiation or trauma, it does not heal on its own. If lymphedema occurs, it can be managed but it is a lifelong condition. If not treated, the protein-rich fluid is a breeding ground for bacteria and infections that can become serious. Untreated, lymphedema tends to worsen over time. How is lymphedema treated? Lymphedema is commonly treated by a physical or occupational therapist certified in lymphedema care. Depending on the severity of edema present, the treatment can involve manual drainage techniques, compression bandaging, and a daily compression garment. The most important thing is to seek treatment at the first sensation of heaviness. Schedule of Measurements A baseline L-Dex measurement is key to identifying small changes after surgery. All patients undergoing breast surgery for cancer should consider lymphedema screening. After surgery, an L-Dex measurement is obtained every 3-6 months for up to five years, and annually thereafter. If an elevation in the L-Dex score is identified, the provider will be able to prescribe treatment based on the stage of lymphedema. For early-stage lymphedema, this may include at-home treatment with temporary use of compression garments. Less frequent L-Dex measurements in the first three years may decrease the chance of detecting lymphedema in an early stage. Insurance Coverage This test is covered by Medicare. Many commercial insurance plans do not cover lymphedema treatment. Patients with commercial insurance may receive a bill to pay out-of-pocket. Is lymphedema avoidable? To decrease the chances of developing lymphedema, after breast cancer treatment a patient should: • Avoid trauma to the breast and arm on the affected side. • Avoid needle sticks and blood pressures on the treated side while you are undergoing your initial breast cancer treatment. • Avoid cuticle injuries during manicures. • Avoid saunas or other extreme heat. • Avoid carrying heavy shoulder strap handbags on the treated side. • Limit sun exposure and minor cuts/abrasions by using sunscreen and gloves. • Maintain a normal weight, which will also decrease the chances of the breast cancer’s recurrence. • Avoid tight jewelry. For more information, visit lymphnet.org.