Why do I need to know about it?
Women who have been treated for breast cancer may be at risk for arm, breast, and chest swelling called lymphedema. Approximately 65-75% of women who undergo breast cancer treatment will develop lymphedema at some point. It may appear soon after surgery, months or years later, or never occur at all. Although it is not curable, it is highly manageable. Lymphedema can occur in both males and females, and falls into two categories: Primary and Secondary.
Primary Lymphedema: Usually caused by congenital abnormalities relating to lymph system. Injuries or severe hormonal fluctuations (ie. puberty or pregnancy) are often triggers.
Secondary Lymphedema: Operations in which the lymph nodes are removed or disturbed are the usual causes. These operations include surgery for breast, ovarian, testicular, or prostate cancer. Irradiation, injuries, inflammation, or infections can also lead to secondary lymphedema. The edema always occurs at a body part in which the drainage is impaired.
What is the lymph system?
Our bodies have a network of lymph nodes and lymph vessels that collect and carry watery, clear lymph fluid, much like veins collect blood from all parts of the body and carry it through the body. Lymph fluid contains proteins, salts, and water, as well as white blood cells, which help fight infections. In the lymph vessels, valves work with body muscles to help move the fluid through the body. Lymph nodes are small collections of tissue that work as filters for harmful substances and help us fight infection.
What is lymphedema & why does it happen?
During surgery for breast cancer, the doctor removes at least one lymph node from the underarm area to see if the cancer has spread. Sometimes doctors remove more than one. When lymph nodes are removed, lymph vessels that carry fluid from the arm to the rest of the body are also removed because they route through and are wrapped around the nodes.
Removing lymph nodes and vessels changes the flow of lymph fluid in that side of the upper body. This makes it harder for fluid in the chest, breast, and arm to flow out of this area. If the remaining lymph vessels cannot drain enough fluid from these areas, the excess fluid builds up and causes swelling called lymphedema. Radiation treatment to the lymph nodes in the underarm can affect the flow of lymph fluid in the arm, chest, and breast area in the same way, further increasing the risk of lymphedema.
Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. It usually develops slowly over time. The swelling can range from mild to severe. Women who have many lymph nodes removed and women who have had radiation therapy for breast cancer have a higher risk of getting lymphedema.
If lymphedema occurs, what are my treatment options?
Lymphedema first appears as swelling. This swelling does not dissipate and can be indented with a fingertip. If left untreated, the swelling may increase and the skin will slowly turn fibrotic and feel hard to the touch. The swelling can increase further and eventually cause the skin to split and weep. It is far better to seek treatment early on, but lymphedema conditions can be improved at any stage. When treatment is sought early, the swelling can be reduced and managed to normal proportions.
Manual Lymph Drainage
This is a special type of skin manipulation conducted by a trained lymphedema therapist. Unlike massage, which implies deep or vigorous rubbing of the skin and underlying tissues, MLD is done with a light touch in order to manipulate the direction of the lymph flow. MLD is conducted on a regular schedule, usually once a day for two to four weeks.
*For contact information on MLD therapists in the GTA area, please contact us at 905-454-5710. We can provide you with a variety of names that come highly recommended by our customers.
With MLD there will come a point where the dramatic change and decrease in swelling of the area will begin to diminish or plateau. This is the point where there will be little if any further change to the volume or size of the area. This is also the time when most patients are fitted for compression garments. Most compression garments are ready-made, but some will have to be custom made if the swelling is still severe. The patient will wear this garment all day, every day. Compression garments should be replaced every six months to maintain optimum compression strength.
Dianne’s Mastectomy has a wide variety of compression garments to fit your needs. We carry both arm sleeves, as well as compression stockings for your legs (needed for those with Deep Vein Thrombosis, blood clots, tired legs, etc). We carry day sleeves, which are worn all day, as well as night sleeves, worn during night. Not everyone who wears a day sleeve will require a night sleeve.
Lymph Drainage At-Home Therapy
Either in conjunction with or instead of MLD, there is an option that provides patients do perform their own lymph drainage at home using a lymph therapy machine. For more information on these pumps, please visit the Lymph Therapy Machine page under the Compression section of our website.