Lymphedema

Lymphedema is a health condition that can result from the surgical removal of lymph nodes from the underarm area or radiation treatment to this area. When lymph nodes are removed or damaged, the lymphatic system is unable to work as effectively in that area and lymph fluid can build up, causing swelling in the arm, hand or chest area.

Not everyone who has had lymph nodes removed or radiation to the underarm area develops lymphedema. For those who do develop it, lymphedema can occur immediately after surgery, or months, even years later. It can be temporary, with mild discomfort, or a life-long, chronic and painful condition.

The risk of developing lymphedema depends on the extent of your breast cancer surgery, the number of lymph nodes removed, the extent of radiation therapy and your weight.

Signs and symptoms

The best defence against lymphedema is detecting and treating it early. Watch out for these early warning signs and speak to your health care provider for advice if you notice them:

• A feeling of tightness in the skin of your arm, armpit, shoulder and/or chest.
• A feeling of heaviness in your arm.
• Swelling/increase in the size of your arm, shoulder, breast, chest, armpit, back, hand or fingers.
• Clothing or jewellery feeling tight on the affected side.
• Aching or stiffness in the arm on the side of your surgery.
• Pain or a feeling of congestion or blockage in your arm.
• Swelling or discomfort that has not gone away 6 to 12 weeks after surgery.

Diagnosis and treatment

If you think you may have signs of lymphedema, speak to your health care provider or a member of your health care team at the hospital where you received your cancer treatment.

If you are diagnosed with lymphedema, ask your health care provider to refer you to a certified lymphedema therapist for treatment. The treatment will focus on therapies to decrease or contain the swelling, including skin care, Manual Lymphatic Drainage massage, compression bandaging and compression garment fitting. Exercise is another aspect of lymphedema treatment—to help improve flexibility and lymph circulation.

There is no cure for lymphedema. However, it can be managed with appropriate treatment and self-care. Detecting and treating lymphedema early can lessen its impact.

Reduce your risk

Here are some things you can do that may reduce your risk of developing lymphedema:

• Do the follow-up exercises that you receive after surgery. After your operation you will be shown exercises that are intended to help restore your upper body mobility. The movements are believed to reduce the risk for lymphedema.
• Look after your skin. Use a moisturizer daily. Try to avoid any injury to the skin on your affected side (the side(s) you were operated on), including cuts, burns, sunburns and insect bites. Apply antibiotic cream immediately to skin abrasions and cuts.
• Avoid constricting your arm. Try to avoid injections or blood pressure monitoring on the affected side(s). Avoid tight-fitting jewelry or restrictive clothing on your arm. Avoid carrying a heavy bag on your affected side.

Avoid extreme temperatures.

• Maintain a healthy body weight. If you are overweight, you have a greater chance of developing lymphedema.
• Look out for signs of infection. Infection can be a cause of lymphedema. If you notice skin redness, swelling or heat on your affected side(s), contact your health care provider immediately.
• Maintain a healthy level of physical activity. Exercise is beneficial for lymphedema risk reduction and management, but too much exercise can overload the lymphatic system and may be a trigger for lymphedema. Exercise carefully, increasing your level of activity gradually, resting frequently and paying attention to your body′s response.