By Steven Chen, chief medical Officer at medtech firm ImpediMed.

As cancer survival rates continue to climb, healthcare providers must address a critical yet often overlooked long term risk for breast cancer patients and survivors: lymphedema. This condition, characterised by the buildup of protein-rich lymph fluid in tissues, can significantly impact survivors’ quality of life if left undetected and untreated.

This month, as we observe Lymphedema Awareness Month, it’s crucial to highlight the importance of managing this potential side effect of breast cancer care.

Dr Steven Chen, chief medical Officer, ImpediMe

Lymphedema extends far beyond simple swelling. When normal lymphatic drainage is disrupted, it leads to stagnant lymphatic flow and an impaired immune response, potentially resulting in serious complications like cellulitis, a dangerous bacterial skin infection.

The condition also carries a substantial financial burden, with management costs ranging from US$14,877 to US$23,167 over just two years. These figures, coupled with the physical and emotional toll on patients, underscore the urgent need for proactive measures in breast cancer care plans.

Transforming Detection and Prevention

Historically, healthcare providers often waited until lymphedema symptoms became visible and chronic before intervening – often too late for optimal treatment.

Today, technological advances have revolutionised our approach to detection. Bioimpedance Spectroscopy (BIS), recognised in national and international guidelines, can detect lymphedema in under 60 seconds, long before symptoms appear.

BIS was also recently added to the National Accreditation Program for Breast Centers (NAPBC) standards as an evidence-based guideline, requiring accredited programs to adopt proactive, guideline-driven survivorship care—further advancing early detection and prevention.

BIS works by sending a small electrical current through the body, measuring the resistance and reactance to this current. This non-invasive approach enables precise measurement of extracellular fluid and total body water, helping determine intracellular fluid, fat mass, and fat-free mass.

The technology’s sensitivity to small fluid changes allows for earlier detection compared to traditional tape measurements, making it an invaluable tool in detecting lymphedema early enough to decrease the risk of chronic lymphedema.

A Comprehensive Approach to Care

The key to managing lymphedema lies in implementing a robust surveillance program that begins before cancer treatment starts. It is recommended that patients establish baseline measurements using BIS technology and maintain regular monitoring throughout and following the completion of cancer treatment for at least three years.

This proactive approach allows for immediate intervention when subclinical changes are detected, often preventing progression to chronic lymphedema.

Physical wellness forms the foundation of effective lymphedema management. Patients can benefit from customised exercise programs that maintain limb mobility and function, while proper skin care prevents infections that could compromise the lymphatic system.

Regular hydration and stress management could also play crucial roles in maintaining lymphatic health. When indicated, compression garments provide essential support in managing symptoms and preventing progression.

Beyond Physical Care

Effective lymphedema management must consider the patient’s entire life context. Healthcare providers should focus on integrating care strategies into patients’ daily routines, considering their work environments, family responsibilities, and personal goals.

This comprehensive approach includes providing access to support resources, educational materials about lifestyle modifications, and tools for self-monitoring and management.

Digital platforms have emerged as valuable resources, offering educational content, exercise programs, and virtual support communities. These tools empower patients to actively participate in their care while maintaining connections with healthcare providers and fellow survivors. The integration of technology into care plans helps ensure consistent monitoring and early intervention when needed.

The Future of Lymphedema Care

As breast cancer treatment continues to improve, our focus must expand beyond survival to encompass the quality of life during and after treatment. The implementation of routine BIS screening represents a step forward in protecting patients from the devastating effects of chronic lymphedema.

Early detection is the key to early intervention, which is the best chance to prevent chronic problems that may require lifelong intensive treatment.

Physicians and other healthcare providers should initiate conversations about lymphedema risk early in the treatment process, making it a routine part of the comprehensive, holistic care of cancer patients.

This early education helps patients understand their risks, encourages them to ask questions about their individual risk factors and early warning signs, reduces unnecessary fear, and empowers them to participate actively in prevention strategies.

The management of lymphedema requires a delicate balance of physical care, emotional support, and lifestyle adaptation. By considering the whole person – their physical needs, emotional well-being, and life circumstances – we can develop more effective, personalized care plans that support long-term health and wellness.

This Lymphedema Awareness Month serves as a reminder that early detection and intervention are crucial in preventing chronic lymphedema. With modern technology and comprehensive care approaches, we have the tools to address this silent threat effectively. By implementing these resources consistently and proactively, we can help ensure that breast cancer survivors not only survive but thrive in their cancer-free lives.

Steven Chen, MD, MBA, serves as the Chief Medical Officer of medical technology company ImpediMed.  Previously, Dr. Chen was the chief medical officer for Avelas Biosciences. He has also served as the chief of breast surgery at UC Davis Medical Center, followed by a position as an associate professor of surgery and as the associate programme director of the surgical oncology training programme at City of Hope National Medical Center in Duarte, California. Dr. Chen is a past president of the American Society of Breast Surgeons and serves on committees for a number of professional societies including the American Medical Association, the Society of Surgical Oncology, and the American College of Surgeons. He is also a practicing surgeon in San Diego, California, and the Director of Surgical Oncology at OasisMD.