Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Cancer Health Center

Font Size

Lymphedema (PDQ®): Supportive care - Health Professional Information [NCI] - Management


Refractory Lymphedema and Complications

If lymphedema is massive and refractory to treatment, or has an onset several years after the primary surgery without obvious trauma, a search for other etiologies should be undertaken. Of particular importance is exclusion of the recurrence of tumor or the development of lymphangiosarcoma, which should be excluded with computed tomography or magnetic resonance imaging. The complication of lymphangiosarcoma is classically seen in the postmastectomy lymphedematous arm (Stewart-Treves syndrome). The mean time between mastectomy and lymphangiosarcoma is 10.2 years, with a median survival of 1.3 years. Clinically, the lesions of lymphangiosarcoma may initially appear as blue-red or purple with a macular or papular shape in the skin. Multiple lesions are common; subcutaneous nodules may appear and should be carefully evaluated in the patient who has chronic lymphedema.[25]


  1. Ridner SH: Pretreatment lymphedema education and identified educational resources in breast cancer patients. Patient Educ Couns 61 (1): 72-9, 2006.
  2. Markowski J, Wilcox JP, Helm PA: Lymphedema incidence after specific postmastectomy therapy. Arch Phys Med Rehabil 62 (9): 449-52, 1981.
  3. Petrek JA: Commentary: prospective trial of complete decongestive therapy for upper extremity lymphedema after breast cancer therapy. Cancer J 10 (1): 17-9, 2004.
  4. Schmitz KH: Balancing lymphedema risk: exercise versus deconditioning for breast cancer survivors. Exerc Sport Sci Rev 38 (1): 17-24, 2010.
  5. Schmitz KH, Ahmed RL, Troxel A, et al.: Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361 (7): 664-73, 2009.
  6. Katz E, Dugan NL, Cohn JC, et al.: Weight lifting in patients with lower-extremity lymphedema secondary to cancer: a pilot and feasibility study. Arch Phys Med Rehabil 91 (7): 1070-6, 2010.
  7. Badger CM, Peacock JL, Mortimer PS: A randomized, controlled, parallel-group clinical trial comparing multilayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Cancer 88 (12): 2832-7, 2000.
  8. Vignes S, Porcher R, Champagne A, et al.: Predictive factors of response to intensive decongestive physiotherapy in upper limb lymphedema after breast cancer treatment: a cohort study. Breast Cancer Res Treat 98 (1): 1-6, 2006.
  9. Didem K, Ufuk YS, Serdar S, et al.: The comparison of two different physiotherapy methods in treatment of lymphedema after breast surgery. Breast Cancer Res Treat 93 (1): 49-54, 2005.
  10. Koul R, Dufan T, Russell C, et al.: Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer. Int J Radiat Oncol Biol Phys 67 (3): 841-6, 2007.
  11. Hinrichs CS, Gibbs JF, Driscoll D, et al.: The effectiveness of complete decongestive physiotherapy for the treatment of lymphedema following groin dissection for melanoma. J Surg Oncol 85 (4): 187-92, 2004.
  12. Szuba A, Achalu R, Rockson SG: Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema. A randomized, prospective study of a role for adjunctive intermittent pneumatic compression. Cancer 95 (11): 2260-7, 2002.
  13. Dini D, Del Mastro L, Gozza A, et al.: The role of pneumatic compression in the treatment of postmastectomy lymphedema. A randomized phase III study. Ann Oncol 9 (2): 187-90, 1998.
  14. Loprinzi CL, Barton DL, Jatoi A, et al.: Symptom control trials: a 20-year experience. J Support Oncol 5 (3): 119-25, 128, 2007.
  15. Shaw C, Mortimer P, Judd PA: Randomized controlled trial comparing a low-fat diet with a weight-reduction diet in breast cancer-related lymphedema. Cancer 109 (10): 1949-56, 2007.
  16. Carati CJ, Anderson SN, Gannon BJ, et al.: Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer 98 (6): 1114-22, 2003.
  17. Kozanoglu E, Basaran S, Paydas S, et al.: Efficacy of pneumatic compression and low-level laser therapy in the treatment of postmastectomy lymphoedema: a randomized controlled trial. Clin Rehabil 23 (2): 117-24, 2009.
  18. Ahmed Omar MT, Abd-El-Gayed Ebid A, El Morsy AM: Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res 165 (1): 82-90, 2011.
  19. Chilvers AS, Kinmonth JB: Operations for lymphoedema of the lower limbs. A study of the results in 108 operations utilizing vascularized dermal flaps. J Cardiovasc Surg (Torino) 16 (2): 115-9, 1975 Mar-Apr.
  20. McNeely ML, Magee DJ, Lees AW, et al.: The addition of manual lymph drainage to compression therapy for breast cancer related lymphedema: a randomized controlled trial. Breast Cancer Res Treat 86 (2): 95-106, 2004.
  21. Williams AF, Vadgama A, Franks PJ, et al.: A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care (Engl) 11 (4): 254-61, 2002.
  22. Andersen L, Højris I, Erlandsen M, et al.: Treatment of breast-cancer-related lymphedema with or without manual lymphatic drainage--a randomized study. Acta Oncol 39 (3): 399-405, 2000.
  23. Ernst E: Massage therapy for cancer palliation and supportive care: a systematic review of randomised clinical trials. Support Care Cancer 17 (4): 333-7, 2009.
  24. Gecsedi RA: Massage therapy for patients with cancer. Clin J Oncol Nurs 6 (1): 52-4, 2002 Jan-Feb.
  25. Tomita K, Yokogawa A, Oda Y, et al.: Lymphangiosarcoma in postmastectomy lymphedema (Stewart-Treves syndrome): ultrastructural and immunohistologic characteristics. J Surg Oncol 38 (4): 275-82, 1988.

This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

WebMD Public Information from the National Cancer Institute

Last Updated: 8/, 015
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

Colorectal cancer cells
New! I AM Not Cancer Facebook Group
Lung cancer xray
See it in pictures, plus read the facts.
sauteed cherry tomatoes
Fight cancer one plate at a time.
Ovarian cancer illustration
Real Cancer Perspectives
Jennifer Goodman Linn self-portrait
what is your cancer risk
colorectal cancer treatment advances
breast cancer overview slideshow
prostate cancer overview
lung cancer overview slideshow
ovarian cancer overview slideshow
Actor Michael Douglas