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Launched in 2003 as an online resource for cancer survivors, the charity achieved global brand recognition a year later by adopting a yellow wristband as its hallmark, a concept Armstrong jointly developed with his sponsor Nike.
The rubber bracelets quickly became a fashion accessory - more than 80 million have been sold - and spawned a wave of imitations in different colors from other charities.
Livestrong's branding, however, had special resonance - the man who inspired them had years earlier beaten cancer and even more remarkably gone on to win the Tour de France, and its hallowed yellow jersey, multiple times.
But, with the cyclist's reputation now languishing in sport's doldrums and up against merciless scrutiny in the court of public opinion, experts say the charity he inspired faces a choice: speak up or stay silent?
"Lance Armstrong has gone from being Livestrong's biggest asset to being their biggest liability," said Sol Levine, a director at Qorvis Communications, a Washington-based public relations firm.
"They have to take care not to have him as their frontman, but it would also be a mistake to actively dissociate themselves."
Livestrong evolved from The Lance Armstrong Foundation - which by name alone was more closely associated with the cyclist - though the two organisations are widely seen as synonymous.
In the last nine years, however, Livestrong has developed its own spirit: Armstrong's image and story do not feature on its website home page though it is found elsewhere on the site.
The charity's most prominent messages instead concern upcoming events and detail where people's donations are spent.
Of the $35.8 million that Livestrong spent last year, 82 percent went on programmes, a high percentage in the charity sector, and its credibility is high.
For that reason, Armstrong's personal troubles are not something Livestrong should address unless it is forced to, said Levine, whose employers specialise in reputation management.
"Livestrong did a lot to break taboos about cancer - the yellow band was a landmark and the organisation is operating under its own power," he said.
"So, I don't think Livestrong is damaged, but Lance Armstrong is no longer an asset. He will always be remembered as a cancer survivor, but that's not what he'll be most remembered for."
Armstrong decided not to contest charges of the US Anti-doping Agency (USADA), though his lawyer said the probe was "pre-determined," and "they were out to get Lance." But the cyclist has undoubtedly lost backing from those who once looked up to him.
"It's so depressing because of the guy's books he wrote that were inspirational to people with cancer, and his cancer charity on one side doing so many positive things. Then you find out this," Britain's Chris Hoy, the six-time Olympic cycling gold medalist, said on Thursday.
So far though, Livestrong has stood back from the controversy. On Wednesday, when the USADA published its dossier, Doug Ulman, the charity's CEO and president, appeared to be following the guidance to stay silent on Armstrong.
"We've got big plans to celebrate 15 yrs of serving survivors. Join us - Oct. 18-21!" he wrote on Twitter, referring to the charity's anniversary.
But given that a Google news search using the terms "Lance Armstrong" and "doping" was generating 57 300 hits late on Thursday, the appetite for the story may soon envelop the charity, and require a more aggressive response.
Chris Edwards, the owner of Reputation Saviors, which specialises in combating negative publicity circulated on the Internet, said if attention moves toward Livestrong, they will have to counter it.
"Right now, they are running with it, but when the entire news media starts to report something, it is a very difficult situation to combat," said Edwards, who is based in Orlando, Florida.
"If that happens to Livestrong they will have to do something. You can't just not answer back."
