Lymphedema Screening and Early Detection Program

Photo credit: Michigan Medicine
What is Lymphedema?
Lymphedema is swelling that occurs when there is build-up of lymphatic fluid in the soft tissues. Lymphedema can be caused by any change to your lymphatic system, which can happen through surgery, injury, or radiation. A person can get lymphedema on the side of their body where they had surgery, on their arms, hands, breasts, or torso (chest, stomach, and back).
Breast Cancer Treatments That Increase Risk of Lymphedema
- Axillary lymph node dissection
- Axillary sentinel node biopsy
- Lymph node radiation
Signs of Lymphedema After Breast Cancer Treatment
It is common to have pain and swelling after surgery. After you heal from surgery, watch for these possible signs:
- A feeling of tightness, pressure, heaviness, aching, or pain in the affected area
- A change in how your jewelry or clothing fits on the affected area
- Swelling that does not get better 6-8 weeks after surgery
Lymphedema Screening and Early Detection Program

Michigan Medicine has designed this program 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. A device in clinic is utilized to measure the fluid status and tissue composition in the arms which 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.
Schedule of Measurements
A baseline L-Dex measurement is key to identifying small changes after surgery. We recommend all patients undergoing lymph node surgery for breast cancer consider a baseline screening measurement. After surgery, an L-Dex measurement is obtained routinely for patients who have undergone an axillary lymph node dissection. If an elevation in the L-Dex score is identified, the provider will refer the patient to occupational therapy for evaluation and treatment. This may include at-home treatment with temporary use of compression garments or therapy for decompressive therapy.
Treatment for Lymphedema

Treatment depends on how severe the problem is. Treatment includes ways to help prevent and manage the condition, and may include:
- Exercise. Exercise helps improve lymph drainage. Specific exercises will be advised by your doctor or physical therapist.
- Bandages. Wearing a compression sleeve or elastic bandage may help to move fluid and prevent the buildup of fluid.
- Diet and weight management. Eating a healthy diet and controlling body weight is an important part of treatment and reducing the risk of lymphedema development.
- Keeping the arm raised. Raising the arm above the level of the heart, when possible, lets gravity help drain the fluid.
- Preventing infection. It’s important to protect the skin in the affected area from drying, cracking, infection, and skin breakdown. Your healthcare provider will advise you about how to care for your skin and nails to help prevent problems.
- Massage therapy. Massage by someone trained in lymphedema treatment can help move fluid out of the swollen area.
Preventing Infection and Injury after Axillary Lymph Node Dissection
Protecting the arm on the side of the surgery is important after breast surgery. Poor drainage of the lymphatic system can cause that arm to be more at risk of infection and less sensitive to extreme temperature. Be aware of activities that put too much pressure on the affected arm. To protect your arm from injury and infection, make sure to do the following:
- Ask for injections and blood draws to be done on the unaffected arm if possible.
- Ask for all blood pressure tests to be done on the unaffected arm.
- Don't wear nightgowns or clothing with elastic cuffs or tight bands.
- Carry your handbag or heavy packages with the unaffected arm.
- Be very careful and use a clean razor when shaving underarms.
- Prevent sunburns and other burns to the affected arm.
- Wear gloves when gardening and when using strong household cleaners.
- Clean the skin of the affected arm daily, gently dry well, and apply lotion.
- Do approved exercises regularly to improve drainage.
- Take good care of your fingernails and don’t cut or bite your cuticles.
- Clean all cuts with soap and water, and then apply antibacterial ointment and a sterile dressing.
- Protect your fingers from needle pricks and sharp objects. Use a thimble when sewing.
- Tell your doctor right away if you have any signs of infection, such as redness, pain, heat, increased swelling, or fever.
Working with Your Healthcare Provider
Talk with your doctor about what you can do to try to prevent lymphedema from happening to you. Make these precautions part of your daily habits and plan to follow them for the rest of your life.
Compare your hands and arms. Look at them in the mirror. Learn what's normal for you so you can notice changes right away. If lymphedema does develop, let your doctor know right away. There are things you can do to try to keep it from getting worse.