Lymphoedema following Breast Cancer

Around 1 in 4 women who have treatment for breast cancer will develop swelling of the arm, called lymphoedema. In most people, this swelling is quite mild and may affect part of the arm, hand or sometimes the breast.

Lymphoedema tends to be a long-term problem but can be well controlled with the correct care and attention.

Causes

Lymphoedema occurs when the lymphatic system cannot adequately drain fluid from part of the body, such as the arm. Blood flows into the arm to provide nourishment to the tissues and any excess fluid is removed through the lymphatic channels and filtered through lymph nodes.

Surgery to remove lymph nodes from the armpit (axilla) and radiotherapy are important treatments for breast cancer but they can interrupt the drainage of lymph fluid from the arm. In some women, lymphoedema starts during or soon after breast cancer treatment while in others it may not develop for several years.

The risk of getting lymphoedema is slightly higher in women who have all the lymph nodes removed from the armpit. High body weight, an injection into the arm, infection (cellulitis) of the arm or a post-operative wound infection may also increase the risk of lymphoedema.

The Lymphoedema Support Network has nationwide groups and can provide advice and support.

Symptoms which may suggest you have lymphoedema of the arm

• Swelling of the arm or part of the arm such as the forearm or hand
• Swelling in or near the armpit and towards the back
• Swelling or hardness of the breast
• Your rings or watch feel tighter
• Your knuckles on the swollen hand are not easily seen.
• Your clothes or sleeves feel restricting.
• Sometimes, the swollen areas can feel firm, especially if you have had lymphoedema for a while.

After breast cancer treatment it is not unusual to notice changed sensations in the arm such as numbness or stiffness of the shoulder.

These may not linked to lymphoedema although you should mention them to your doctor or breast care nurse.

What next?

See your Doctor or Breast Care Nurse if you are concerned.

The sooner lymphoedema is diagnosed the easier it is to treat.

Finding out you have lymphoedema can sometimes feel like the last straw, particularly after cancer treatment,

However lymphoedema can be well maintained and by following the advice below, life can resume as normal!

Remember you are not alone! The Lymphoedema Support Network has nationwide groups and provides advice and support.

Keeping your arm healthy

Your advice leaflet

There are four main areas of lymphoedema care:

• Skin and preventative care
• Exercises
• Specialised massage (called manual lymph drainage)
• Compression using lymphoedema sleeves or a course of arm bandaging

Compression bandaging can be the first step to reduce limb volume. Actico inelastic bandages are suitable for this and Mollelast digit bandaging also.

Activa provide full training through its Lymphoedema Training Team on arm, leg and digit bandaging. Once limb volume has been achieved the Actilymph armsleeves can be worn to manage the condition.