Breast cancer patients at the Upstate Cancer Center are now routinely screened for lymphedema using a new technology called the SOZO Digital Health Platform. This device is used before treatment to detect lymphedema as early as possible.

Lymphedema is a protein-rich fluid accumulation that, in breast cancer survivors, can affect the arm, breast, and/or trunk area. Treatments for breast cancer such as lymph node biopsy or removal, radiation therapy, and/or certain types of chemotherapy can increase an individual’s risk for developing breast cancer-related lymphedema.

Lauren Buck, PT, DPT, CLT-LANA, a certified lymphedema therapist, said that breast cancer-related lymphedema occurs in approximately 25 to 30 percent of all breast cancer patients over their lifespan. Buck said patients with breast cancer were screened in the past with a different machine but not routinely. The new technology available with the SOZO digital platform gives providers a wealth of information about the patient, including changes in fluid levels in their arms and their total body composition.  As part of new guidelines from the National Comprehensive Cancer Network (NCCN), it is highly recommended that providers get baseline L-Dex scores for patients before treatment. An L-Dex score is used to determine if fluid is building up in an arm that is at risk for lymphedema.

To obtain the measurement, the patient typically stands on the device, like they would on a bathroom scale, but can sit if needed. Hands are placed on a platform in front of them so both hands and feet are in contact with the connection surfaces. The test takes about 30 seconds. 

Buck said that early detection of lymphedema leads to a better outcome for patients.

“Bioimpedance spectroscopy (the technology used in the SOZO digital platform) helps identify the onset of lymphedema in an arm or leg before patients experience noticeable swelling,” she said. “Research has shown that the early detection of lymphedema using L-Dex combined with treatment can reduce progression to chronic lymphedema by 95% in breast cancer patients.”

Buck said that when lymphedema is detected early, daily use of compression garments is typically recommended for most patients. This is for a limited amount of time and is typically not needed lifelong.

 When lymphedema becomes chronic, treatment is much more time-consuming for the patient. The gold standard treatment for patients affected by lymphedema is Complete Decongestive Therapy or CDT. CDT is a treatment strategy that includes the following interventions: manual lymphatic drainage, skin and nail care, compression bandaging, remedial exercises and compression garment recommendations and fittings. Once lymphedema has progressed to a chronic stage, lifelong management is necessary.

Buck has been assessing patients on the SOZO every Friday in the multidisciplinary clinic at the Cancer Center since June 2024 to obtain a baseline measurement before breast cancer treatment.

She said it is preferred that patients obtain a baseline L-Dex score before treatment and are reassessed during regular follow-up visits using the SOZO device. Lymphedema assessment with the SOZO L-Dex score is recommended to be done every 3 months for the first three years and then every six months for years four and five, followed by annually afterwards. She emphasizes that it’s never too late to begin breast cancer-related lymphedema education and surveillance using the SOZO device.  



“With active surveillance using bioimpedance spectroscopy, risk stratification and lymphedema prevention education, we are hopeful to decrease the percentage of patients in our Breast Cancer program that go on to develop chronic lymphedema,” she said.

The SOZO digital platform can be used for a wide range of patients due to the data that can be obtained using the device. Upstate’s rehabilitation providers are looking to extend the use of this technology for screening and management of not only patients with breast cancer but of those with different types of cancer or other medical conditions. 

Caption: Lauren Buck, DPT, with the new machine in use at the Upstate Cancer Center used for lymphedema screening for breast cancer patients.