Understanding Lymphedema

Lymphedema, a potential side effect of breast cancer surgery and radiation therapy, can appear in some people during the months or even years after treatment ends.

Lymph is a clear, colourless fluid that contains a few blood cells. The lymphatic system is a network of tiny vessels and small, bean-shaped organs called lymph nodes that carry lymph throughout the body. The lymphatic system is part of the immune system, which helps protect and maintain the fluid in the body by filtering and draining lymph and waste products away from each body region. The lymphatic system also helps the body fight infection. 

The lymph nodes under the arm are called the axillary lymph nodes. They drain the lymphatic vessels from the upper arms, the majority of the breast, neck, and underarm area.  Often during breast cancer treatment, some or all of the nearby lymph nodes   under the arm are removed or treated with radiation. This disrupts the flow of lymph, which can lead to swelling. So lymphedema occurs when too much lymph collects in any area of the body. If lymphedema develops in people who’ve been treated for breast cancer, it usually occurs in the arm and hand, but sometimes it affects the breast, underarm, chest, trunk, and/or back. Swelling can worsen and become severe and skin sores or other problems can develop. Affected areas are also more likely to become infected.

When many lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema for the rest of her life. Radiation treatments to the under arm lymph nodes can cause scarring and blockages that further increase the risk of lymphedema.

(Adapted from www.hopkinsmedicine.org)
Treating lymphedema with compression sleeves

Compression sleeves and garments (a finger-less glove or a gauntlet, which does not have individual finger openings, and is often worn with a sleeve), do just what their name suggests: apply pressure to the arm, hand, or trunk to keep lymph moving in the right direction. Sleeves are tighter at the bottom than they are at the top, which helps create the graded (or “gradient”) pressure that keeps the lymph moving out of the arm.

Lymphedema  sleeves or garments  must be properly fitted by someone with experience. An improperly fitted sleeve can make lymphedema worse by placing too much or too little pressure on certain areas of the limb — which can cause fluid backup to worsen. A trained “fitter” is needed to take measurements of the arm, hand or chest in order to select the correctly sized sleeve, gauntlet or glove.

(Adapted from www.breastcancer.org)