Lymphedema is a potential side effect of breast cancer surgery and radiation therapy that can appear in some people during the months or even years after treatment ends.
Lymph is a thin, clear fluid that circulates throughout the body to remove wastes, bacteria, and other substances from tissues. Edema is the buildup of excess fluid. 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.
Breast cancer surgery, especially when several lymph nodes are removed, and radiation can cut off or damage some of the nodes and vessels through which lymph moves. Over time, the flow of lymph can overwhelm the remaining pathways, resulting in a backup of fluid into the body’s tissues.
People with lymphedema also are at high risk for cellulitis, a serious bacterial infection of the skin and underlying tissue. The more lymph nodes that have been removed or damaged, the harder it may be for the lymphatic system to deal with injury. Cuts or even small breaks in the skin — sometimes not even visible to the naked eye — can get infected, causing symptoms such as redness, tenderness, and warmth. In some cases, these symptoms can spread from the original injury up the arm or into the upper body. A spreading rash that is warm and tender indicates cellulitis. Cellulitis requires immediate medical attention and treatment with antibiotics.
A small study has found that an advanced pneumatic compression device used at home reduced cellulitis episodes by nearly 80% in people with lymphedema and lowered their healthcare costs related to lymphedema.
The study was published in the November 2015 issue of JAMA Dermatology. Read the abstract of “The Cutaneous, Net Clinical, and Health Economic Benefits of Advanced Pneumatic Compression Devices in Patients With Lymphedema.”
The study looked at the medical records of 718 people diagnosed with lymphedema from 2007 to 2013 (374 of the people had been diagnosed with cancer and 344 had not been diagnosed with cancer).
All the people in the study received the advanced pneumatic compression device that they used at home. The device was the Flexitouch System made by Tactile Medical. The device sequentially inflates over areas of the body affected by lymphedema to move the excess fluid out of the affected area.
The researchers compared:
- rates of cellulitis
- use of lymphedema-related physical therapy
- outpatient hospital visits
- inpatient hospitalizations
for the year before the study participants got the device to the year after they got the device.
Among people who had been diagnosed with cancer, cellulitis episodes went down 79% — from 21.1% to 4.5% — in the year after they started using the device.
Among people who hadn’t been diagnosed with cancer, cellulitis episodes went down 75% — from 28.8% to 7.3% — after they started using the device.
Lymphedema-related physical therapy and outpatient hospital visits were lower in both groups after they used the pneumatic device, which lower the participants’ lymphedema-related healthcare costs:
- costs were 37% lower among people diagnosed with cancer
- costs were 36% lower among people who hadn’t been diagnosed with cancer
"This could be a game-changer in the area of lymphedema care," said Prof. Sheila Ridner of the University of Minnesota School of Public Health. "Up to 10 million people in the United States are living and oftentimes suffering with symptoms of lymphedema. The idea that a home advanced pneumatic compression device can provide relief, decrease the number of cellulitis episodes, and save money is an important new option for patients."
The results of this study are very encouraging. Still, more research is needed before we know for sure that the compression device can safely be used at home by large numbers of people. So stayed tuned to Breastcancer.org for the latest information on lymphedema treatments.
While there’s no way to know for sure whether you’ll develop lymphedema after breast cancer treatment, you can help yourself by learning more about it. Know your risk factors, take steps to reduce your risk, and be aware of early symptoms. Left untreated, lymphedema can worsen and cause severe swelling and permanent changes to the tissues under the skin, such as thickening and scarring.
There are steps you can take to lower your risk of lymphedema or manage the condition if you’ve already been diagnosed. Visit the Breastcancer.org Lymphedema pages to learn more.