Lymphoedema

Lymphoedema, or swelling of the arm or breast, is a condition associated with the removal of, or damage to, lymph nodes during breast cancer treatment. It can develop after surgery that removes lymph nodes, or after radiotherapy to the armpit.

The swelling is caused by a build up of fluid in the tissues in the arm or breast.

There is no known cure for lymphoedema, however early diagnosis and treatment make it easier to manage.

It is important to remember that not all women who have lymph nodes removed during their surgery will develop lymphoedema.

Reducing your risk of developing lymphoedema

There are a number of ways to reduce your risk of developing lymphoedema, including:

• Taking good care of your skin:
  • keep your skin moist using a moisturising cream such as sorbolene
  • protect your skin from the sun with clothing and sunscreen
  • if shaving your armpit, use an electric razor instead of a wet razor
  • use insect repellent and, if bitten, use a product to reduce the itchiness of the bite
  • protect your hands with gloves while washing dishes or gardening
  • treat any cuts or breaks to the skin with antiseptic
  • if a cut, bite or break to the skin becomes red or inflamed, or your arm swells quickly or becomes red and warm, see your doctor as soon as possible as you may have an infection that requires antibiotics

• Keeping active:
  • Gentle muscle movement increases lymph flow and reduces the risk of fluid accumulating. A gentle regular exercise routine is recommended. Studies have shown that moderate exercise does not exacerbate lymphoedema in women who already have it and does not make women more susceptible to developing it. There is also some evidence to suggest that exercise may even help prevent lymphoedema.

• Avoiding using the arm on the side of your surgery for blood pressure measurements, injections, blood samples or intravenous drips. (While there is not yet enough evidence to determine whether these procedures can trigger lymphoedema, these precautions are recommended).

Symptoms of lymphoedema

Lymphoedema can occur any time after surgery, even many years later.

Early symptoms are:

• swelling of the arm, breast or hand (you may notice your rings, sleeves or wristbands feel tight)
• feelings of discomfort, heaviness or fullness in the arm or breast
• aching, pain, tension in the arm, shoulder, hand, chest or breast area.

If you develop any of these symptoms, you should seek prompt advice from a member of your medical team.

Managing lymphoedema

There is no known cure for lymphoedema but there are ways to manage it, including good skin care, gentle exercise, lymphatic drainage massage and the use of compression garments on the affected arm. These treatments are designed to reduce and control swelling, improve the range of movement of the affected area and prevent infections.

There are some emerging treatments such as laser therapy, which aims to soften scar tissue and improve the function of the lymphatic vessels, and pneumatic pumps, which go around the arm and inflate and deflate at intervals. Further research is still needed on the effectiveness of these treatments, but you may like to talk to your doctor or lymphoedema practitioner if you are interested in learning more about them.

To find a lymphoedema practitioner in your local area, you may like to visit The National Lymphoedema Practitioners Register (NLPR) , which is a public register of lymphedema practitioners in Australia and New Zealand, including physiotherapists, massage therapists, occupational therapists and nurses.

Compression garments can be quite costly, but there are subsidies available in most Australian states and territories that cover some or all of the cost of garments. BCNA’s fact sheet on lymphoedema compression garment subsidies includes a list of subsidies available in Australia.

More information

• Download BCNA's reducing your risk of lymphoedema and travel tips for reducing the risk of lymphoedema fact sheets for advice and tips on managing and reducing the risk of lymphoedema.
• Download BCNA's lymphoedema compression garment subsidies fact sheet.
• The Beacon issue 45 contains an article about Lymphoedema -- 'Lymphoedema 10 myths'.
• Read BCNA 's position statement on Lymphoedema.
• The Cancer Australia's Guide for women with early breast cancer, available in My Journey Kit has some useful information on lymphoedema.
• The Lymphoedema Association of Australia website provides information and reference material.
• The Australasian Lymphology Association's National Lymphoedema Practitioners Register (NLPR) is a public register of lymphoedema practitioners in Australia and New Zealand. You can use the register to search for a lymphoedema practitioner in your local area.
• The Westmead Breast Cancer Institute has a Lymphoedema brochure which you can order free of charge through their website.