Breast cancer treatment can lead to various side effects. One concern for individuals undergoing treatment is lymphedema, a condition involving swelling. Understanding this potential outcome helps patients recognize symptoms and seek appropriate care.
What is Lymphedema
Lymphedema is a chronic condition characterized by swelling, typically in an arm or leg, but it can affect other body parts like the chest or head. This swelling occurs due to a buildup of lymph fluid in the body’s tissues. The lymphatic system, a network of vessels, nodes, and organs, plays a role in the immune system and drains excess fluid from tissues.
When the lymphatic system is compromised, it cannot adequately drain lymph fluid, leading to its accumulation. This disruption can result in symptoms such as a feeling of heaviness or tightness in the affected area. The swelling might initially be soft and temporary, but it can become more severe and persistent without intervention.
Why Lymphedema Occurs After Breast Cancer Treatment
Lymphedema frequently develops following breast cancer treatment due to damage to the lymphatic system. Surgical procedures often involve removing lymph nodes, particularly those in the armpit (axillary lymph nodes). This removal directly disrupts lymph fluid flow, impeding drainage from the arm, breast, and chest areas.
Radiation therapy to the lymph nodes, especially in the underarm region, also contributes to the risk. Radiation can cause scarring and inflammation within lymphatic vessels and nodes, creating blockages that obstruct lymph flow. The risk increases when both surgery and radiation therapy are administered. Other factors like obesity, infection, or trauma can also contribute to lymphedema development.
How Common is Lymphedema After Breast Cancer
The occurrence of lymphedema after breast cancer treatment varies considerably, influenced by the type and extent of surgical intervention and whether radiation therapy was included. Sentinel lymph node biopsy (SLNB), which involves removing only a few lymph nodes, has a lower incidence of lymphedema compared to axillary lymph node dissection (ALND).
Studies show lymphedema may affect approximately 5% of patients who undergo SLNB alone. The rate can be higher, around 16% to 29.5%, for those who have ALND, where a greater number of lymph nodes are removed. The addition of radiation therapy to ALND further elevates the risk. Patient factors such as higher body weight also play a role.
Signs of Lymphedema and What to Do
Recognizing the signs of lymphedema after breast cancer treatment is important for early management. Common indicators include swelling in the arm, hand, fingers, chest, or breast on the side of treatment. Individuals may also notice a feeling of tightness, heaviness, or fullness in the affected area, or that clothing, jewelry, or watches feel tighter than usual.
Other symptoms can involve decreased flexibility in the hand, wrist, or shoulder, or a new aching sensation. The skin in the affected area might feel tight or appear thickened. If any of these signs are observed, it is advisable to consult a healthcare professional. Early detection allows for prompt guidance on managing the condition, which may involve skin care, exercises, or compression garments.