During surgery for cancer, nearby lymph nodes are often removed. This disrupts the flow of lymph, which can lead to swelling. This is lymphedema. Lymphedema can affect one or both arm, the head and neck, the belly, the genitals, or the legs. Swelling can worsen and become severe. Skin sores or other problems can develop. Affected areas are also more likely to become infected.
Often during breast cancer treatment, some or all of the lymph nodes under the arm are treated with radiation. The lymph nodes under the arm are also called the axillary lymph nodes. They drain the lymphatic vessels from the upper arms, from most of the breast, and from the chest, neck, and underarm area.
When many lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema for the rest of her life. Radiation treatments to the under arm lymph nodes can cause scarring and blockages that further increase the risk of lymphedema. Lymphedema may occur right after surgery or radiation, or months or even years later.
Types of Lymphedema
Types of Lymphedema:
- A mild type of lymphedema can occur within a few days after surgery and usually lasts a short time.
- Lymphedema can also occur about 4 to 6 weeks after surgery or radiation and then go away over time.
- The most common type of lymphedema is painless and may slowly develop 18 to 24 months or more after surgery. It does not get better without treatment.
Lymphedema can happen any time after surgery or radiation to the lymph nodes. The risk continues for the rest of the person’s life. Lymphedema can’t be cured, but it can be managed. Any swelling should be checked by a healthcare provider right away.
There’s no way to know who will and won’t get lymphedema, but there are things that can be done to help prevent it.
Can lymphedema be prevented?
Women treated for breast cancer who have good skin care and who exercise after treatment are less likely to develop lymphedema. Newer types of lymph node surgery have also helped decrease lymphedema risk. But there is no sure way to prevent lymphedema.
Symptoms of Lymphedema
The main symptom of lymphedema after breast cancer treatment is swelling of the arm on the side where lymph nodes have been removed. The amount of swelling may vary. Some people may have severe swelling (edema) with the affected arm being several inches larger than the other arm. Others will have a milder form of edema with the affected arm being slightly larger than the other arm.
Other symptoms of lymphedema may include:
- Feeling of fullness, heaviness, or tightness in the arm, chest, or armpit area
- Bra, clothing, or jewelry don’t fit as normal
- Aching or new pain in the arm
- Trouble bending or moving a joint, such as the fingers, wrist, elbow, or shoulder
- Swelling in the hand
- Thickening of or changes in the skin
- Weakness in the arm
If you notice any of these symptoms, see your healthcare provider right away. Treatment needs to be started right away to keep lymphedema from getting worse.
How is lymphedema diagnosed?
There are no tests for lymphedema. Instead, your healthcare provider will ask about your medical history and give you a physical exam. You’ll be asked about:
- Past surgeries you’ve had
- Any problems after your surgeries
- When the swelling started
- If you’ve had severe swelling (edema) in the past
- What medicines you’re taking
- What other health conditions you have, such as high blood pressure, heart disease, or diabetes
Imaging tests, measures of volume, blood tests, and other tests may be used to diagnose lymphedema.