By Mei R.
Fu, PhD, RN, ACNS-BC
breast cancer treatment is an abnormal
accumulation of lymph fluid in the
affected arm, hand, fingers, wrist,
elbow, shoulder, neck, breast, chest
area, or any combination of these areas.
The word “affected” means the same body
side on which you received breast
surgery or radiation. The excess fluid
build-up leads to persistent swelling
and other distressing symptoms,
including pain, heaviness, firmness,
tightness, and numbness.
usually develops slowly over time but it
can also develop soon after surgery or
radiation or even years later after
breast cancer treatment. Not everyone
who has been treated for breast cancer
will develop lymphedema, but many will.
During surgery for breast
cancer, the doctor usually removes part
or the whole breast and at least one of
the lymph nodes and some connected lymph
vessels from the underarm or chest area
to see if the cancer has spread. This
changes the flow of lymph fluid in your
affected body side and leads to the
excess fluid build-up. Radiation can
also affect the flow of lymph fluid in
your affected body side in a similar
Please call your doctor if you notice
the following symptoms as they may indicate
an early onset of lymphedema:
feels full or heavy.
Skin in your affected arm or body
side feels tight or firm.
the affected body side (including
breast, hand, fingers, elbow,
shoulder, neck, breast, or chest
Less movement or flexibility in your
affected hand, fingers, wrist or
lymphedema following breast cancer
treatment can be gradual or sudden. It
is still not fully understood why some
patients are more prone to fluid
build-up than others even with
similarity in surgical treatment,
numbers of lymph nodes removed, and
radiotherapy. Noticeable swelling is
often absent during the initial
development of lymphedema, but patients
may report feelings of tightness and
heaviness. With gradual onset,
lymphedema typically occurs two to five
years after treatment, but it can also
happen as many as 15 to 30 years later.
sudden onset, swelling develops rapidly,
usually within 24 hours and often
individuals are able to identify the
triggers, such as air travel, infection,
or injuries (e.g., cuts, insect bites,
pinpricks, burns). Usually, immediate
administration of antibiotics can clear
the infection, while elevation of the
limb helps to reduce the swelling. To
reduce the risk of injury-triggered
lymphedema, it is important to treat
cuts, insect bites, pinpricks, or burns
immediately with antibiotic cream to
also important to follow appropriate
risk reduction behaviors.
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