Breast Cancer Related Lymphedema (BCRL) is one of the most dreaded side effects of breast cancer treatment and may occur in close to 50% of patients following axillary node dissection and radiation therapy (XRT). It can be seen in up to 20% of patients even following limited axillary dissection (sentinel node biopsy) followed by XRT. BCRL is a chronic debilitating condition that is frequently misdiagnosed and treated too late. It is the abnormal accumulation of protein-rich fluid in the interstitium which results in limb swelling, chronic inflammation and reactive fibrosis in the surrounding tissues.
What you should know is that recent evidence supports the notion that if diagnosed in the subclinical stage, BCRL may be reversible or at least its progression may be significantly halted. BCRL may be divided into subclinical (stage 0) and clinical (stages I,II,III) presentations, the difference being that the subclinical stage is not visible to the naked eye. Subclinical BCRL may exist for month or years before overt BCRL occurs and is more easily managed than advanced stages.
Appropriate surveillance for lymphedema onset is essential and medically necessary. There is a new device that is FDA approved and every breast surgeon should have one. ImpediMed’s L-Dex® technology utilizes the characteristics of frequency dependent current flow to quantify changes in extracellular fluid in the patient’s arm. These changes can aid medical providers in clinically assessing patients for lymphedema of the arm in women. L-Dex technology is specific for extracellular fluid. As fluid accumulates, L-Dex values increase. The device provides an immediate result and is provided with software for tracking changes in patient’s L-Dex values over time. Regular perometry or bioimpedance spectroscopy screenings (L-Dex) pre-surgery and in the years after successful cancer treatment can improve quality of life and reduce fear and the development of irreversible lymphedema.
If you have lympedema and have to wear a compression stocking, I’ve found a great site that was founded and developed by a breast cancer patient who wanted a nicer alternative. www.lympherdivas.com take a look at some of them below. Outcome is directly related to compliance so have fun with it.