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          Are You at Risk for Lymphedema Following Breast Surgery?

          The risks associated with breast surgery are numerous and, for the most part, temporary and easily managed. However, there is one breast surgery complication that many women often don't hear about until it's too late: lymphedema.

          What is Lymphedema?

          Lymphedema is a build-up of fluid in soft body tissues that occurs when the lymphatic system is damaged or blocked. The lymphatic system collects viruses, bacteria and other waste products from throughout the body and delivers them to the lymph nodes, which flush waste out from the body.

          Swelling develops where the blockage occurs, usually in one or both arms or legs. Women who develop lymphedema after undergoing breast surgery experience swelling in their arms and upper chest. This upper extremity lymphedema is a common complication following breast augmentation surgery, breast cancer surgery, prophylactic mastectomy or breast reconstruction because these procedures are performed in close proximity to, or require the sampling of, lymph nodes located in the armpits. Up to 70 percent of women who undergo surgery to treat their breast will develop lymphedema.

          The swelling can range from quite mild to an extreme that makes using the limb impossible. Other symptoms of lymphedema include feelings of heaviness, tightness, achiness or discomfort in the limb(s), recurring infections and a hardening and thickening of the skin.

          Complications from lymphedema include infections like cellulitis (bacterial infection of the skin) and lymphangitis (infection of the lymph vessels). Any injury to an arm or leg can provide an entry point for these infections. Untreated, lymphedema can result in a rare form of soft tissue cancer called lymphangiosarcoma that shows up as blue-red or purple marks on the skin.

          While there is no cure for lymphedema, it can be managed through careful treatment of the affected limb(s) that focuses on reducing the swelling and controlling the pain.

          Lymphedema Treatment

          Treatment of upper extremity lymphedema often takes a multi-pronged approach that includes one or more of the following options:

          • Range-of-motion exercises
          • Manual lymph drainage, a special massage technique that's used to gently move lymph fluid from swollen areas to healthy lymph nodes.
          • Elastic bandages wrapped around the arm to encourage the lymph fluid to flow toward the trunk of your body.
          • Pneumatic compression, a treatment that involves wearing a sleeve over the affected arm that's attached to a pump. The pump inflates and deflates the sleeve, putting pressure on the arm and moving the lymph fluid to reduce swelling.
          • Compression sleeves, which also are used move lymph fluid out of the affected arm. Proper fit is crucial; custom-made garments are available.

          Therapy that combines several of these treatments is known as complete decongestive therapy, or CDT.

          Visit other pages on this site to learn about other breast surgery complications such as capsular contracture  and double bubble.

          This article is a special contribution to by Cathy Kleinman-Barnett, OT. Kleinman is a lymphedema/edema specialist in the Outpatient Rehabilitation Department of the Northwest Medical Center in Margate, FL. She completed a master's degree in occupational therapy at Nova Southeastern University in Davie, FL. Kleinman received her lymphedema specialty certification from the Academy of Lymphatic Studies and the Dr. Vodder School of North America. She received her bachelor's degree from Rider College in Lawrenceville, NJ.

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