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School of Medicine
Following breast cancer treatment, some patients may suffer from lymphedema. Lymphedema is a chronic condition caused by lymphatic fluid accumulating in the tissues. It most often affects the limbs, but it can cause swelling in other parts of the body. Primary lymphedema develops when lymphatic vessels are missing or damaged; secondary lymphedema develops when lymph vessels and nodes are removed or damaged.
The medical community does not yet fully understand why some cancer patients suffer from lymphedema after treatment and others remain unaffected. However, the surgeons at the Johns Hopkins Breast Center have a low occurrence of patients with lymphedema following a sentinel node biopsy or axilliary node dissection.
Is there any way to prevent lymphedema?
While there is no guarantee about preventing lymphedema, the following guidelines are helpful:
- Do not get needle sticks or blood pressure in the arm where the lymph nodes were removed
- Be vigilant in treating injuries and cuts that happen in that arm
- Learn about preventative measures before your surgery and request that it be part of your preoperative teaching
Many breast centers teach patients about preventative measures for lymphedema after their surgery. At Johns Hopkins Medicine, we have certified lymphedema specialists on our Physical Medicine and Rehabilitation team to teach patients about prevention and treatment of lymphedema. We find the best time to teach patients is before surgery, so they are vigilant during their initial recovery.
The risk of developing lymphedema continues for the rest of your life so it is critical to be aware of the risks. Patients having an axillary node dissection will receive this type of instruction. Patients undergoing sentinel node biopsy have a low incidence of developing lymphedema since the procedure was developed to reduce the risk of lymphedema.
What are the treatment options for lymphedema?
Decongestive therapy by a certified lyphedema specialist remains the primary prescription for lymphedema. During decongestive therapy, a physical therapist, occupational therapist, or other specially trained professional massages the affected areas, helping to move excess fluid to healthy tissue. They will also give exercises to do to help ease swelling. Between sessions, it is recommended to wear compression garments to increase tissue pressure and keep fluid moving.
If decongestive therapy is not proving to be effective, a surgical procedure called lymphovenous bypass or a vascularized lymph node transfer may be an option. During this procedure, a reconstructive surgeon moves lymph nodes from the groin area to the armpit and reconnects them to the blood vessels.
MYTH: I should avoid weightlifting activities if I have lymphedema. Get the facts.
Watch plastic surgeon Justin Sacks and lymphedema therapist Elizabeth Erhardt discuss lymphedema management and treatment options.