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Lymphedema After Breast Cancer Surgery
The term lymphadema comes from the lymphatic system, which helps coordinate the immune system's function to protect the body from foreign substances and includes an extensive network of lymph vessels and lymph nodes. Here's how the lymphatic system works:
- Excess fluid is collected from the space between tissues in the body and moves through the lymph vessels. The fluid (now called lymph) isn't pumped through the body like blood, but instead is "pushed" through the lymph system as the vessels are compressed by surrounding muscles.
- Filters called lymph nodes remove certain harmful substances from the lymph fluid, such as bacteria and debris. The fluid from most tissues or organs is filtered through one or more lymph nodes before draining into the bloodstream.
What Is Lymphedema?
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.
There are two types of lymphedema: primary and secondary.
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 and can 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 can occur at any time after the surgery. If untreated, it can become worse.
Following breast cancer surgery, a doctor will examine you and take arm measurements. Sometimes, there may be redness or pain in the arm, which may be a sign of inflammation. Depending on your symptoms, your physician will then consider the best treatment options for you.
What Are the Signs and Symptoms of Lymphedema?
If you suspect 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.
- Skin tightness.
- 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.
WebMD Medical Reference
Breast Cancer Guide
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
October is National Breast Cancer Awareness Month, and a new study reveals why a high number of women with the disease still prefer to have the entire breast surgically removed instead of just the tumor. It's not always because doctors recommend it.
