Andrea Morken, a certified lymphatic specialist, works on the leg of Josette DePasse during an hour-long session of lymphatic drainage. DePasse's symptoms began after she twisted her ankle in sixth grade. She's now 33, and she wasn't given a correct diagnosis until three years ago, leaving her with severe, irreversible damage.

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A Tucson doctor is hoping to bring earlier detection and more awareness of a condition that patients can develop after cancer surgery, particularly if the lymph nodes are removed, biopsied or irradiated.

If untreated, it leaves its sufferers with bulging, unsightly and painful swelling for the rest of their lives.

Dr. Eric B. Whitacre, director of the Breast Center of Southern Arizona and an American Society of Breast Surgeons board member, has begun using a new device that helps detect lymphedema in patients before it's too late.

Lymphedema is an accumulation of lymphatic fluid that causes swelling, most often in the arms or legs, and occasionally in other parts of the body. It can develop when lymphatic vessels are missing or impaired, or when lymph nodes are removed.

Estimates of the prevalence among breast cancer patients run from 6 percent to 40 percent.

The reason for the wide range is possibly that lymphedema can easily be dismissed as a minor problem at its early stages. Sometimes it can be confused with weight gain or water retention.

The cases often show up within the first two years after surgery.

The condition is not the same as edema, which occurs when veins can't pump blood to the heart. However, untreated edema can progress into a combined venous-lymphatic disorder that is treated the same as lymphedema.

Whitacre first saw the L-Dex medical device at a conference, and he initially walked by its vendors. But he went back for a couple of reasons. First, he knows firsthand that lymphedema is so tough to detect at its early stages — doctors typically use nothing more sophisticated than a tape measure to check for swelling — and that it's dangerous and painful for patients in its later stages.

But it remains somewhat of a perplexing condition, too.

"The literature on lymphedema is so confusing," Whitacre said. "There are so many different causes and ways to find it."

There was another reason the medical device, made by ImpediMed Inc., caught Whitacre's attention. The L-Dex, which has been cleared by the Food and Drug Administration, was mentioned in a five-year study conducted by the National Institutes of Health and the National Naval Medical Center. The study, published last year in the journal Cancer, showed that early detection led to the most successful outcomes for lymphedema patients.

"Clinically, we haven't had a test for lymphedema," Whitacre said. "We'd measure the circumference of the arm. The other method is water displacement using a big tank."

Other times, patients pick up on the problem because jewelry is tight or they feel a sense of heaviness.

But by the time an arm shows a visible discrepancy, the lymphedema often has reached an advanced stage. The L-Dex device can detect early signs, before swelling is visible.

The L-Dex works a little like an electrocardiogram — wires attached to a small computerized box not much bigger than an iPod are affixed with adhesive pads to the patient's at-risk extremities. It works by measuring the amount of fluid outside the cells.

The L-Dex should be used before surgery as a baseline, and then regularly over the next 18 months when patients are most at risk for developing lymphedema. But it also should be used periodically in the years after surgery.

For some cancer survivors and others at risk, a low-level lymphedema can occur 10 to 15 years after the initial primary treatment and develop into a condition that has a serious impact on overall health and quality of life.

The condition can be treated with compressive garments and manual lymphatic drainage.

Whitacre hopes the device will alleviate the fear of lymphedema that many breast cancer survivors have.

He's also expecting to improve patient health.

"In a period of six weeks, you may be able to totally reverse the lymphedema," he said.