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Lymphedema After Breast Cancer Surgery

  • Lymphedema Symptoms and Treatment

  • Lymphedema is the collection of protein-rich lymph fluid in the tissues of the hand, arm and/or chest wall on the side of the breast surgery. Lymphedema causes painless swelling of the hand, arm and/or chest. The condition occurs when the normal lymphatic drainage in the chest and arm are injured during surgery and/or radiation therapy.

    Most women who undergo breast surgery and radiation therapy do not develop lymphedema. However, it is important to learn and follow a few prevention strategies to reduce your risk of developing lymphedema.

  • Lymphatic system

  • The lymphatic system is part of your immune system. It consists of a series of vessels which run along side your circulatory system (veins) and lymph nodes which are located around major organs and in certain tissue (under your arm for instance). The lymph system helps to filter out dead cells, protein and waste products in your veins. It also plays a role in mobilizing your immune system to fight off an infection.

    During your breast surgery, the lymph vessels and nodes are usually cut and removed, especially if you had a sentinel or complete axillary lymph node dissection. This damages and disrupts the flow of lymphatic fluid in that region. Radiation therapy may cause further scarring. Most of the time, your body can adapt to these changes without excess fluid accumulating in the arm on the side of the breast surgery. However, lymphedema can occur from overusing that arm or from an infection, bug bite, cut or some other type of injury that causes excess fluid to build up that the body cannot remove. The buildup of lymphatic fluid causes swelling in the arm.

  • Signs and symptoms of lymphedema

  • Signs and symptoms of lymphedema include:

    • Feelings of tightness in the arm

    • Noticing that rings or other arm/finger jewelry has become tight

    • Weakness in the arm

    • Pain, aching or heaviness in the arm

    • Redness, swelling or signs of infection

  • Lymphedema treatment

  • Lymphedema is usually treated by physical methods and with medication.

    Physical methods:

    • Support the arm in a raised position.

    • Undergo manual lymphatic drainage (a specialized form of very light massage that helps to move fluid from the end of the arm toward the trunk of the body).

    • Wear custom-fitted clothes that apply controlled pressure around the arm.

    • Clean the skin carefully to prevent infection.

    Compression garments:
    • These should cover the entire area of swelling.

    • Compression pumps may be used with garments, but only under the supervision of a trained health care professional.

    Medication:
    • Antibiotics may be used to treat and prevent infections.

    Pain Management:
    • Pain is caused by the swelling and pressure on nerves, loss of muscle tissue and function, or scar tissue causing shortening of muscles and less movement in joints.

    • Pain may be treated with medications, relaxation techniques, and/or transcutaneous electrical nerve stimulation (TENS); however, the most successful treatment is to decrease the lymphedema.

    Dietary Management:
    • Blood protein levels and weight should be monitored regularly, and patients should be encouraged to eat protein-rich foods.

  • Lymphedema support

  • Coping with lymphedema after breast cancer is especially difficult. Group and individual counseling can help by providing emotional support and information about ways to prevent lymphedema. Check with your health care provider to find a lymphedema support group near you. The information in this section is not meant to replace the individual attention, advice, and treatment plan of your oncologist and medical team.

    More on Lymphedema

    Risk factors and occurrence of lymphedema

    Prevention of lymphedema