Understanding Lymphedema
A Comprehensive Guide for Breast Cancer Patients
What is Lymphedema?
Lymphedema is a chronic condition that affects many breast cancer survivors due to the damage caused to the lymphatic system during cancer treatment. This comprehensive guide will empower you with the knowledge you need to navigate your lymphedema journey with confidence and take proactive steps towards maintaining your overall health and well-being.
Insights from expert
“Education in the early stages of breast cancer diagnosis can significantly reduce the risks of developing chronic conditions associated with breast cancer treatment, such as lymphedema and orthopedic issues.”
James B Saviers II, MS, OTR/L, CLT-LANA
LLL Medical Advisor | Lymphedema Specialist/Occupational Therapist
The Lymphatic System: Your Body's Vital Drainage Network
The lymphatic system is a complex network of vessels, nodes, and organs that plays a crucial role in maintaining fluid balance, absorbing nutrients, and supporting immune function. This intricate system works alongside the circulatory system to transport a clear, colorless fluid called lymph throughout the body. Lymph contains white blood cells, proteins, and other substances that help fight infection and remove waste products from the tissues.
Key components of the lymphatic system include:
Lymph capillaries
These tiny, permeable vessels absorb fluid and other molecules from the spaces between cells.
Lymph collectors
Unlike blood vessels, lymph collectors pump lymph fluid independently of the heart, moving it towards the lymph nodes.
Lymph nodes
These small, bean-shaped structures filter lymph fluid, trapping bacteria, viruses, and other harmful substances. Lymph nodes also produce and store white blood cells, which are essential for fighting infection.
Understanding how the lymphatic system functions is crucial for recognizing the signs and symptoms of lymphedema and taking steps to manage the condition effectively.
Breast Cancer Related Lymphedema (BCRL): What You Need to Know
Breast cancer related lymphedema (BCRL) is a specific type of lymphedema that can develop as a result of damage to the lymphatic system during breast cancer treatment.
This damage can occur due to various factors, including:
Lymph node removal
Sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) can reduce the lymphatic system’s capacity to drain fluid effectively.
Radiation therapy
High-energy radiation used to destroy cancer cells can also cause scarring and damage to the lymph nodes and vessels.
Scar tissue formation
Surgical scars and radiation-induced fibrosis can impede the flow of lymph fluid, leading to accumulation and swelling.
When the lymphatic system’s transport capacity is overwhelmed, lymph fluid begins to build up in the affected arm, hand, breast, or trunk, causing the characteristic signs and symptoms of lymphedema.
These may include:
- Swelling or puffiness
- Feeling of heaviness or tightness
- Skin changes, such as thickening or pitting
- Aching or discomfort
- Reduced range of motion
Early detection and intervention are essential for managing BCRL effectively and preventing the condition from progressing.
Managing Lymphedema: A Multi-Faceted Approach
Lymphedema management begins with risk reduction education during the pre-operative phase and continues throughout the breast cancer treatment process. Certified lymphedema therapists (CLTs) play a vital role in assessing, treating, and educating patients to help them maintain their quality of life.
Working closely with a multidisciplinary team of healthcare professionals, including CLTs, physical therapists, and occupational therapists, can help you develop a personalized lymphedema management plan that meets your unique needs and goals.
Complete decongestive therapy (CDT) is the gold standard for lymphedema treatment and consists of two phases:
1. Treatment Phase
- Skin and nail care to prevent infection
- Manual lymphatic drainage (MLD) to stimulate lymph flow
- Multi-layer compression bandaging to reduce swelling
- Therapeutic exercise to enhance the effects of MLD and bandaging
2. Maintenance Phase
- Ongoing self-care practices, including skin care, self-MLD, and compression garments
- Regular follow-up with a CLT to monitor progress and adjust treatment as needed
In addition to CDT, other management strategies may include:
- Compression garments
- Pneumatic compression devices
- Kinesiology taping
- Low-level laser therapy
- Surgical interventions, such as lymph node transfer or lymphovenous bypass
Assessing Your Lymphedema Risk Factors
It's essential to discuss your individual risk factors with your healthcare team and work together to develop a personalized risk reduction and surveillance plan.
This may include:
- Pre-operative baseline measurements and assessments
- Post-operative education on lymphedema risk reduction practices
- Regular follow-up assessments to detect early signs of lymphedema
- Referral to a CLT for further evaluation and treatment, if needed
Several factors can increase your risk of developing BCRL, and understanding these risk factors can help you take proactive steps to reduce your risk or catch symptoms early.
Some of the most significant risk factors include:
- Extent of lymph node removal (SLNB vs. ALND)
- Number of lymph nodes removed
- Radiation therapy to the breast or regional lymph nodes
- Advanced stage of cancer at diagnosis
- Chemotherapy
- Post-surgical complications, such as infection, seroma, or axillary web syndrome
- Obesity (BMI ≥ 30)
- Genetic predisposition
By staying informed, vigilant, and proactive, you can significantly reduce your risk of developing lymphedema or catch it early when it is most treatable.
Expert Guidance on Lymphedema Care After Breast Cancer
About James B Saviers II, MS, OTR/L, CLT-LANA
James Saviers is a highly experienced occupational therapist and certified lymphedema therapist, specializing in helping breast cancer survivors manage and prevent lymphedema. With over a decade of experience in the field, James is dedicated to providing comprehensive, patient-centered care and education to support women throughout their breast cancer journey.
Empowering Yourself on Your Lymphedema Journey
At Learn Look Locate, we understand the challenges and uncertainties that come with navigating lymphedema after breast cancer. That’s why we are dedicated to providing you with the most up-to-date, expert-guided information and resources to support you every step of the way.
Remember, you are not alone in this journey. By educating yourself, working closely with your healthcare team, and connecting with others who have experienced lymphedema, you can take control of your health and well-being. Together, we can create a community of empowered breast cancer survivors who thrive in the face of lymphedema.