WHAT EVERY WOMAN WITH BREAST CANCER SHOULD KNOW ABOUT LYMPHEDEMA
following Surgery or Radiation Therapy for Breast Cancer.

Women who have been treated for breast cancer may be at risk for lymphedema, or swelling in the chest area or the arm. Most women who have had breast cancer will not develop this side effect, but 10 to 20 percent will. It is not possible to predict who will get lymphedema, for this reason prevention, recognizing it early and treating it promptly is the best way to manage it.

WHAT IS LYMPHEDEMA?

Lymphedema is one of the most troubling complications after breast cancer surgery, particularly following a mastectomy. It is caused by interruption of the lymph drainage around the operated breast, which produces swelling of the chest and the arm on the side of that breast, causing discomfort and an abnormal appearance of the arm. Many women find that lymphedema can add further physical and emotional strain to the traumatic experience of having a mastectomy. The signs of lymphedema may include:
Swelling, heaviness, skin feels tight, less movement and flexibility, tingling, aching....
You also may want to examine your upper body in front of a mirror. If you notice any of the signs listed above, call your doctor or health care provider.

If any part of your affected arm or underarm area (axilla) feels hot, is red and has sudden swelling, please contact your doctor immediately. These symptoms could signal an infection (cellulitis). and may require antibiotics.

HOW DOES LYMPHEDEMA DEVELOP?
Lymph is a clear fluid that contains mostly white blood cells (those blood cells that fight infection).
Lymphedema that develops after treatment for breast cancer is called

secondary lymphedema, and it develops because there is a disruption in the normal lymphatic drainage. This interruption in the lymph drainage can be caused by:
Surgery, particularly removal of the lymph glands, Trauma or injury to the arm, Infection that may develop following breast surgery, Tumor-related obstruction of the lymph drainage, Radiation.
 

PREVENTION FOR LYMPHEDEMA
You should report any symptoms of pain or swelling to your doctor as soon as you notice them; do not wait for symptoms to worsen.
Some preventive strategies include:
Avoid trauma or injury to the affected arm. Blood drawing, vaccinations or intravenous lines should be avoided in that arm, if at all possible.
Avoid constriction in the affected arm. Tight fitting clothing, blood pressure monitoring or any activity that can cause a tourniquet effect would interfere with lymph flow and should be avoided.
Try to prevent infection. Practice meticulous skin and nail hygiene to prevent an entry point for infection. Use skin moisturizes to prevent dry, cracked skin. Use topical antibiotics on small skin breaks or abrasions, such as a paper cut. Avoid heavy and strenuous exercises. Avoid the application of heat to the limb, it can encourage edema. Please contact us for a complete Precaution and Prevention list.

TREATMENT FOR LYMPHEDEMA
If you are diagnosed with lymphedema, there is effective treatment to reduce the swelling, prevent it from getting worse, and limit the risk of infection. Typically, the therapy is prescribed by your doctor and should be given by an experienced therapist.
Treatment should encompass the range of symptoms a woman is experiencing. Eliminating discomfort, improving range of motion in the arm, and decreasing psychological distress are important outcomes of therapy. Often doctors refer patients to clinicians or lymphedema programs with expertise in treating lymphedema.

Complex physical therapy — This is a multi modality approach that uses lymphdrainage massage, skin care, exercises, compression wrapping and compression garment. It is considered an effective treatment for lymphedema that is unresponsive to compression therapy alone.

Compression garments - Applying external pressure immediately after surgery, to the chest wall can mobilize edema and ultimately reduce swelling. Our Mastectomy Vest is recommended by Surgeons and hospitals after surgery for up to 6 month.

Compression for the arm can be achieved by using an lymphedema arm sleeve, or by wrapping the arm in short stretch bandages. Whichever method is used, proper fit is important so that the garment does not worsen edema in any one area of the arm.

Exercise - While exercise is not recommended during the immediate recovery phase of surgery, it can be helpful in the chronic phase of recovery. Non fatiguing exercises can enhance muscle contraction that will improve lymph flow and reduce swelling.

PLEASE contact us for any questions, Dr. Kropp will answer your questions and concerns in the best possible time.