Lymphoedema after breast cancer

15/05/2018

Lymphoedema of the arm affects 20 to 30% of women treated for breast cancer. This uncomfortable condition, with a risk of complications, requires compression therapy and drainage of lymph fluid.

During breast cancer treatment, the lymph nodes in the underarm region on the side of the affected breast often need to be removed (by axillary lymph node dissection or sentinel lymph node biopsy). In some cases, the lymph then has difficulty circulating properly and builds up, causing an increase in the volume of the arm on the side where breast surgery was performed.

Variable time to onset and course

Lymphoedema generally occurs within 18 months following treatment, but sometimes years later. The risk factors for developing the condition primarily include radiation exposure during radiotherapy, being overweight, a poorly balanced diet and hormonal status in women. Often moderately extensive, it sometimes only affects the hand, sometimes the whole arm and even the armpit. The oedema may be mild or severe, hard or soft, temporary or persistent.

Treating to feel better and prevent complications

Lymphoedema causes feelings of heaviness and limitation of movements, adversely affecting mobility and quality of life. In addition, since the immune system is less effective, the skin on the arm is at higher risk of infection. This lymphoedema should therefore be treated promptly, in two phases:

  • the first “intensive” phase, to reduce the volume of the arm, via lymphatic drainage and the application of bandages by a physiotherapist;
  • the second “maintenance” phase, to maintain this reduction, via the wearing of compression garments, such as compression sleeves.

Treatment should be combined with a healthy lifestyle and, if necessary, specific exercises and skincare. Surgery involving lymphovenous anastomosis (diverting of vessels to bypass the damaged area) or lymph node transfer (graft) is sometimes offered when these treatments have not been effective. This surgery can help reduce discomfort.

Documentary sources
Site Web Inca : Lymphoedème. DiSipio T. et al., Incidence of unilateral arm lymphedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol, 2013 May; 14(6): 500-15 Hayes S.C., Rye S., Battistutta D., Newman B./ Prevalence of upper body symptoms following breast cancer and its relationship with upper body fuction and lymphedema. Lymphology, 2010, 43, 178-187. Vignes, M. Coupé, F. Beaulieu, L. Vaillant, pour le groupe « Recommandations » de la Société Française de Lymphologie – Les lymphœdèmes des membres : diagnostic, exploration, complications – Journal des Maladies Vasculaires (2009) 34, 314-322