Thanks to a grant from the Komen Foundation, we are currently able to offer L-Dex assessments for a limited time, free of charge!
Lymphedema Assessment with L-Dex
At Center For Breast Care, Inc., we pride ourselves on offering our patients the most advanced breast care available. As part of our focus on quality care and disease prevention, we now offer all breast cancer patients an FDA-cleared test for the clinical assessment of arm lymphedema.
What Is Lymphedema?
Some women who have been treated for breast cancer are at risk for lymphedema, or arm swelling. Our bodies have a network of lymph nodes and lymph vessels that carry lymph fluid to all parts of the body, similar to the way blood vessels circulate blood. The lymph fluid contains white blood cells, which help us fight infections.
During surgery for breast cancer, it is customary to remove at least one of the lymph nodes from the underarm area to see if the cancer has spread. Some lymph vessels that carry fluid from the arm to the rest of the body will also be removed because they are intertwined with the nodes. Removing lymph nodes and vessels from the underarm changes the way the lymph fluid flows within that side of the upper body. At times, this may make it more difficult for fluid in the arm to circulate to other parts of the body. If the remaining lymph vessels cannot remove enough of the fluid in the breast and underarm area, the excess fluid builds up and causes swelling, or lymphedema. Radiation treatment to the lymph nodes in the underarm can also affect the flow of lymph fluid in the arm and breast area in the same way, increasing the risk for lymphedema.
Lymphedema usually develops slowly over time. The swelling can range from mild to severe, and it may develop at any time following surgery or radiation therapy. The risk of developing lymphedema increases depending on the number of lymph nodes removed, but it may occur with the removal of only one lymph node; we do not fully understand why some women develop lymphedema while others do not.
Lymphedema Treatment:
If you are diagnosed with lymphedema, various techniques such as massage, exercise, manual lymphatic drainage, wearing of a compression garment, and mechanical compression can reduce the swelling, keep it from getting worse, and limit the risk of infection.
Early Detection and Prevention
Up until recently, we have only been able to detect the development of lymphedema through physical signs, such as tightening of the skin of the hand and forearm, tightness associated with rings and watches, and changes in arm measurements. The problem was that by the time swelling became obvious, it was more difficult to treat.
Now, for the first time, we have a way to clinically assess patients for lymphedema before swelling and discomfort occur. By using a simple, non-invasive assessment called an L-Dex™ (lymphedema index) test, we will be able to more precisely evaluate you for early evidence of lymphedema, before tightness and swelling develops. The good news is that with early detection and intervention, recent scientific evidence from the National Institutes of Health show that we can potentially halt and even reverse the progression of lymphedema.
The L-Dex test is non-invasive and painless. Patches are placed on the skin in a manner similar to having an EKG reading; the test takes approximately 5 minutes. Usually the test will be performed prior to surgery to obtain a baseline reading, and then at various intervals after surgery. Periodic testing after treatment will help us determine if fluid is building up in one of your arms even before the obvious physical signs of lymphedema have developed. If we note that the fluid content is increasing, early referral to physical therapy will result in more effective treatment. The L-Dex, manufactured by ImpediMed is the only FDA-cleared device specifically for the detection of lymphedema, and I am excited to be one of the few facilities in the area to offer the L-Dex test to my patients.
