Lymphedema and Breast Cancer

People who have been treated for breast cancer are at risk for developing lymphedema (limf-ah-deema). This pamphlet will give you information about lymphedema and its treatment.

When does BCRL usually occur?

Breast cancer-related lymphedema may appear weeks, months, or even years after breast cancer surgery or regional lymph node radiotherapy, but most of them occur within 3 years after surgery. If you are experiencing or have experienced treatment, you should seek professional advice for prevention and treatment of lymphedema.

What is the lymphatic system, and what is its function in the body?

Lymph fluid, lymphocytes (white blood cells), lymph vessels, and lymph nodes are part of the body’s lymphatic system. The lymphatic system removes cell waste and protects the body from infections and disease. It does this by collecting extra fluid, proteins, and other substances from the body’s tissues. It is moved through the body in tiny vessels that are much smaller than veins. Bean-shaped lymph nodes filter the fluid to remove waste and bacteria. Other lymph vessels carry the lymph back to the bloodstream.

What is lymphedema?

Lymphedema is a breakdown of lymphatic refluxes leading to the accumulation of protein-rich fluids in the stroma. When the lymphatic vessel load exceeds the transport capacity of the lymphatic system, it will cause the accumulation of filtrate, which will lead to lymphedema. Surgical removal of lymph nodes (lymph node resection) and radiotherapy are the main causes of lymphedema in breast cancer patients, but Breast Cancer-Related Lymphedema (BCRL) can also be caused by lymphatic or lymph node obstruction or by tumor cell infiltration (cancerous lymphangitis)

Some early symptoms of BCRL：

•Puffiness or edema in the hands or arms

•Clothes, underwear or jewelry feel tighter than before

•Grooves or marks are left on the skin when taking off jewelry or clothing

•A feeling of swelling in the breast, chest or arm

•Arms feels heavy

What are the risk factors for lymphedema?

Breast cancer and related treatments are the most common causes of upper limb lymphedema. The main risk factors for BCRL include the diagnosis of invasive cancer, axillary lymph node dissection/destruction, radiotherapy, local infection, and obesity, but other factors may also play a role.

We recommend the following precautions to protect affected limbs:

•Monitor limb condition, including measuring and recording upper limb size. Measurements should be taken at the palms of the hands (if edema is present), the wrists, and 10 cm below and above the elbow joint

•Carefully maintain skin hygiene and nail care to prevent infections that may cause cellulitis

•Protect exposed skin, including using sunscreen and wearing gloves when participating in activities that may cause skin damage

•Wear suitable graded pressure sleeves

•Avoid medical procedures that require puncturing the skin of affected limbs (e.g., vaccination, acupuncture, venous bleeding, venous catheterization, venography)

•Manage your weight

BCRL prevention advice for daily life:

•Exercise

Adhering to proper exercise habits can not only help blood circulation and maintain your ideal weight, but also control edema. It is recommended that exercise be carried out under the guidance of a medical professional.

•Repeated actions

For most people, some repetitive movements will not be a big problem, such as mopping the floor, using a vacuum cleaner, painting, or training on a rowing machine. However, some patients can develop lymphedema due to these repetitive actions. When you perform repetitive activities, please pay attention to how your arms and hands react. If you feel swelling or pain during or after the activity, you should immediately stop the activity, reduce its intensity, or shorten its length.

•Take a hot shower/bath or use a sauna

For some people, lymphedema could be caused by taking a hot shower or bath, or using a sauna. If you want to do any of these activities, start by doing it for a few minutes, paying close attention to possible edema reactions in your body.
Traveling by airplane

Before boarding the plane, during the flight, and after landing, you should drink plenty of water. Stretch your arms from time to time while you are waiting for the plane and during the flight. If you do not have lymphedema, it is not necessary to wear a pressure sleeve, but you must wear pressure sleeves when flying if you already have lymphedema. The selection and wearing of pressure sleeves needs to be carried out under the guidance of a physiotherapist.

Our Rehabilitation services for BCRL：

•Breast cancer postoperative posture correction training

•Breast cancer postoperative rehabilitation exercises

•Prevention of complications after breast surgery

•BCRL Risk Factors Screening

•Assessment of upper limb range of motion and muscle strength

•Multilayer compression bandage wrapping

•Detumescence exercises

•Kinesio Tape

•Intermittent Pneumatic Compression

•Customized home exercise plan for lymphedema prevention