Lymphedema and Breast Cancer
In an earlier edition of Your HealthMagazine a 4-question self-quiz on a topic vital to every woman with breast cancer was presented lymphedema. This article will expand and clarify exactly what Lymphedema is and what its side-effects are for the post-mastectomy woman. Women who have been treated for breast cancer may be at risk for lymphedema, or arm swelling. Many women who have had breast cancer will not develop this side effect, but many will.
What Is Lymphedema?
Our bodies have a network of lymph nodes and lymph vessels that carry lymph fluid, similar to the way blood vessels circulate blood to all parts of the body. The lymph fluid contains white blood cells which help us fight infections. During surgery for breast cancer, the doctor usually removes at least one of the lymph nodes from the underarm area to see if the cancer has spread. Some lymph vessels that carry fluid from the arm to the rest of the body are also removed because they are intertwined with the nodes.
Removing lymph nodes and vessels from the underarm changes the way the lymph fluid flows within that side of the upper body. This makes it more difficult for fluid in the arm to circulate to other parts of the body. If the remaining lymph vessels cannot remove enough of the fluid in the breast and underarm area, the excess fluid builds up and causes swelling, or lymphedema. Radiation treatment to the lymph nodes in the underarm can affect the flow of lymph fluid in the arm and breast area in the same way, increasing your risk for lymphedema.
Lymphedema usually develops slowly over time. The swelling can range from mild to severe, and it can develop soon after surgery or radiation treatment. It can also develop months or even years later. Women who have many lymph nodes removed and women who have had radiation therapy to the underarm area may have a higher risk of developing lymphedema. Doctors still do not fully understand why some patients are more likely to have problems with fluid build-up than others. As breast surgery and treatment continue to become more conservative (that is, as more women are treated with lumpectomy) and as research advances are made with procedures such as the sentinel lymph node biopsy (a newer procedure which allows the surgeon to remove only 1 or 2 lymph nodes), doctors expect that fewer women will develop lymphedema. Although much remains to be learned about this condition, there are ways that you can care for your arm and breast area to reduce your chances of having future problems. Once lymphedema has started, it cannot be cured, but early and careful management can reduce symptoms and keep the condition from getting worse.
We are indebted to the American Cancer Society (ACS) for the information contained in this article and for much, much more.Community support of ACS permits the development of educational materials like this article and thus is worthy of your consideration for support. Next month please look for an article about how women with lymphedema can reduce swelling after surgery or radiation.