Lymphedema is an abnormal buildup of fluid that causes swelling, most often in the arms or legs. The condition develops when lymph vessels or lymph nodes are missing, impaired, damaged, or removed. The lymph nodes are part of the lymphatic system which helps fight off infection and clears debris from the body.
There are two types of lymphedema: primary and secondary.
Surgery is recommended as the primary treatment of breast cancer in pregnant women. Since radiation in therapeutic doses may expose the fetus to potentially harmful scatter radiation, modified radical mastectomy is the treatment of choice. Conservative surgery with postpartum radiation therapy has been used for breast preservation. An analysis has been performed that helps to predict the risk of waiting to have radiation.[3,4]
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Primary lymphedema is rare and is caused by the absence of, or abnormalities in, certain lymph vessels at birth.
Secondary lymphedema occurs as a result of a blockage or interruption that alters the flow of lymph through the lymphatic system. It may develop from an infection, cancer, surgery, scar tissue formation, trauma, deep vein thrombosis (a blood clot in a vein), radiation, or other cancer treatment.
Who Is at Risk for Developing Lymphedema?
People who have had any of the following procedures may be at risk for developing lymphedema:
Simple mastectomy in combination with axillary (arm pit) lymph node removal
Lumpectomy in combination with axillary lymph node removal
Modified radical mastectomy in combination with axillary lymph node removal
Combined cancer surgery and radiation therapy to a lymph node region (such as the neck, armpit, groin, pelvis, or abdomen)
Radiation therapy to a lymph node region
Lymphedema can occur within a few days, months, or years after surgery. A small amount of swelling is normal for the first four to six weeks after surgery.
What Happens After My Breast Cancer Surgery?
Lymphedema develops after breast surgery because there is an alteration in the pathway that drains the fluids involved in the immune system. It may occur at any time after the surgery. If untreated, it may become worse.
Following breast cancer surgery, a doctor will take arm measurements. Sometimes, there may be redness or pain in the arm, which may be a sign of inflammation. Depending on your symptoms, the doctor will then consider the best treatment options for you.
What Are the Signs and Symptoms of Lymphedema?
If you suspect you have any of the symptoms of lymphedema listed below, call your health care provider right away. Prompt treatment can help get the condition under control.
Swelling in the arms, hands, fingers, shoulders, chest, or legs; the swelling may occur for the first time after a traumatic event (such as bruises, cuts, sunburn, and sports injuries), after an infection in the part of the body that was treated for cancer, or after an airplane trip lasting more than three hours.
A "full" or heavy sensation in the arms or legs
Decreased flexibility in the hand, wrist, or ankle
Difficulty fitting into clothing in one specific area
Tight-fitting bracelet, watch, or ring that wasn't tight before