If you're just hearing the term lymphedema for the first time, you're likely running to search google for information. You'll click on various links and scroll through a variety of pictures of legs and arms that have obvious swelling and changes in skin characteristics. These pictures can be overwhelming when you see the severity of some of these cases. Your search results may also leave you wondering, can you get lymphedema in places other than your extremities? The answer is yes! You can get lymphedema almost any place in your body. Today we're going to talk about a fairly common presentation of lymphedema that often goes under diagnosed. If you have breast cancer, or know someone who does, please keep reading!
Breast lymphedema can occur after having surgery for breast cancer, including lumpectomies/partial mastectomies and lymph node biopsies or dissections. After surgery it's normal to have discomfort and swelling, so how do you know if you have lymphedema?
Your risk for lymphedema increases dramatically if you've had surgery and radiation treatments. The most common time of onset is about 3 months after radiation has been completed, but can occur sooner or later than that (even up to years after). Common signs of breast lymphedema include: breast heaviness, achiness or fullness, thickened skin, dimpling of the skin that resembles the peel of an orange skin, pitting edema (swelling that is easily indented when pressure is applied) and indentations of/around scars or raised scar tissue.
Of course, you'll want to rule out any other causes of breast pain and swelling, such as infections, seromas or an advancement of breast cancer. Talk to your doctor first about these concerns, then find a certified lymphedema therapist (CLT) to be treated.
Treatment for lymphedema will include several different steps, known as complete decongestive therapy.
1. Your therapist will perform manual lymphatic drainage (a very specific form of massage) to encourage the fluid to drain toward areas in your body that you have a healthy lymphatic supply. This technique is very gentle and should not be painful. Your therapist can also teach you this technique to perform yourself at home.
2. Your therapist will apply compression to encourage the fluid to drain. Compression therapy is variable and can include traditional bandaging techniques, as well as taping techniques. You'll often keep compression on for at least 24 hours before it's removed or replaced with another form of compression.
3. Your therapists will teach you exercises to perform to encourage your lymphatic system to pump more efficiently. These will likely include lots of breathing exercises in conjunction with more traditional exercises. If you have access to water or a pool, this can also be a great place to exercise to get a combination of compression (from the water) and exercise.
4. Your therapist will talk to you about techniques to improve skin care, such as moisturizing with low pH lotions.
5. You and your therapist will come up with a maintenance plan. Unfortunately, lymphedema does not go away, so it's important to manage it with long-term compression garments. Your therapist can help you choose compression garments that will fit you properly to wear on a daily basis.
6. If you struggle to maintain a healthy weight, or have gained weight after going through breast cancer treatment, consider seeing a nutritionist for help. One of the largest risk factors for developing lymphedema is obesity and/or weight gain after breast cancer treatments.
Looking for a CLT near you? Check out the search function on the National Lymphedema Network's website: https://nlnmembership.com/directory/#!directory/map/ord=lnm