Lymphoedema is swelling caused when lymph fluid accumulates in the surrounding tissue due to impaired function of lymphatic vessels. Throughout our body there is a network of lymph nodes and vessels that carry lymph fluid, similar to blood.
Destruction of lymphatic vessels by cancer, axillary surgery (sentinel node biopsy or axillary dissection), axillary radiotherapy, and infection are all known causes of lymphedema in patients with breast cancer. Obesity also increases the risk of lymphedema.
Previously it has been recommended for women to avoid having blood pressure checks on that arm, blood tests or intravenous lines, to avoid air travel and heavy lifting. But recent studies have shown that these are not associated with increased risk of lymphedema. The only factor that increased the rate of lymphedema is infections on that limb.
I recommend that all patients slowly resume normal activities and exercise as tolerated. If immediate reconstruction has been performed, then the exercise regimen should be discussed with plastic surgeon. I would also recommend stretching and light yoga both before and after surgery.
Lymphoedema presents a serious problem for many breast cancer survivors, with documented rates of 6 up to 40%. Since the advent of sentinel node biopsy the rates of lymphoedema have decreased to 7-22%. Average time to lymphedema development is 7 months, but can develop years after the operation/treatment.
Treatment may consist of:
Manual Lymphatic drainage/massage – performed by certified treatment providers
Compression bandaging/garments - performed by certified treatment providers
Exercise
Skin and Nail Hygiene
Low Level Laser Therapy (LLLT) - Low level Laser therapy is also used for treatment of scars and contractures as well as muscle injuries. Some practitioners also use it to minimise post-operative pain related to muscle tightness. There are no reported complications from LLLT.