The cutting-edge LYMPHA protocol is now available to women who are scheduled to undergo complete axillary lymph node dissection. Prior to lymph node dissection, blue dye is injected into the patient's upper arm. Then, during the surgery, the presence of the dye guides the surgeon in identifying lymphatics from the arm which are reattached microscopically to a branch of a vein in the armpit area. This approach re-establishes lymphatic flow, which significantly reduces the patient's risk of developing lymphedema.
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Bioimpedance spectroscopy is a painless, noninvasive technique used to measure extracellular fluid in the limbs by passing low-dose electric current through the limb. Before surgery for breast cancer, patients undergo a baseline measurement to determine their normal fluid levels. After surgery, patients will be assessed again at frequent intervals (usually during regular office visits). Through continuous monitoring, any change in fluid levels will be detected in their earliest stages, even before any arm swelling may be visible. Begun in 2010, this protocol has already succeeded in identifying patients who had subclinical levels of lymphedema. Detecting and treating lymphedema at far earlier stages than ever before has the potential to significantly improve the quality of life for many patients.