Treatment for Lymphedema

Lymphedema following treatment for breast cancer is an abnormal swelling of the arm or hand. It can develop immediately following surgery or even years later. Some patients also report swelling in the breast or chest wall. It may occur following removal of some or all of the axillary lymph nodes, or those lymph nodes in the armpit, or after radiation treatments directly to those nodes.

It occurs when lymphatic vessels of the arm are no longer able to remove all the lymphatic fluid that is normally filtered from the tissue. Sometimes lymphedema is triggered by an injury, infection, burn, or other trauma to the arm. Studies have also shown that weight gain after treatment for breast cancer can strain the lymphatic system.

Lymphedema after - Sentinel lymph node biopsy

Studies show the risk of developing lymphedema is very, very low. As few as 0 to 7 out of every 100 patients will develop lymphedema after this procedure. The John Wayne Cancer Institute at Providence Saint John’s Health Center is an acknowledged leader in developing the low risk procedures that make the incidence of lymphedema so low.

Lymphedema after - Axillary lymph node dissection

Studies show the risk of developing lymphedema is higher. About 15 to 25 out of every 100 patients will develop lymphedema following this procedure.

It can be difficult to determine the risk of developing lymphedema because there is no standard test for diagnosing it, and the disruption of lymph flow affects people differently.

Some cases of lymphedema can even be caused by older treatment methods.

Symptoms of lymphedema

The best treatment for lymphedema is prevention. To reduce your chance of developing lymphedema:

  • Avoid getting breaks in the skin that can lead to infection of the affected arm. If you do get a cut, clean the area well and apply antibacterial ointment and a bandage. Watch the area for signs of infection until it heals.
  • Use a moisturizer daily to help protect the skin of your arm and hand.
  • Manicure your nails carefully. Do not cut the cuticles.
  • Wear gloves when gardening, cleaning, or washing dishes.
  • Use care when removing hair under your arm. Do not use a straight razor or hair removal (depilatory) cream, as they can cause skin breaks.
  • Use insect repellent to avoid stings.
  • Avoid tight jewelry, clothing, or anything that can cause a tourniquet effect (such as blood drawing or the taking of blood pressures) on the affected arm. If both arms are involved, ask your doctor how to proceed.
  • Take care not to get sunburned. Use sunscreen with an SPF of at least 15.
  • Avoid the use of local heating and hot packs on the affected arm and shoulder.

If you’re developing lymphedema, you may experience visible swelling in the arm, hand, breast, or chest wall; a sensation of heaviness, achiness, or tightness in the arm; easy fatigability of the arm; or pain in the arm. Occupational therapists and physical therapists can treat lymphedema using a variety of techniques, including compression garments, exercise, and/or gentle massage.

If you notice arm swelling, redness, or pain, it is very important to consult your doctor so that infection, if present, can be treated. Additional testing such as a Doppler ultrasound of the veins of the arm to look for blood clots or an evaluation of other possible causes of arm swelling may be necessary.

At the Margie Petersen Breast Center, we start our patients on antibiotics at the first sign of lymphedema. Providence Saint John’s also has physical therapists to assist in your treatment should you develop lymphedema.