Treatment Programs

Breast Cancer-related Lymphedema

Massachusetts General Hospital Cancer Center offers lymphedema screening for women who have been treated for breast cancer.

What Is Lymphedema?The lymphatic system collects excess fluid, proteins and other substances from the body's tissues. This fluid is called "lymph." If the flow of lymph in the body is blocked, fluid can collect in the fatty tissues under the skin. The swelling that results is called lymphedema.

Lymphedema can develop weeks, months or years after surgery or radiation therapy, each of which can prevent the lymphatic system from functioning efficiently. Lymphedema can occur anywhere in the area of body that was treated. Breast cancer-related lymphedema can occur in the breast, chest wall, arm and/or hand.

Possible early signs of lymphedema include:

  • Puffiness or swelling
  • Clothing, bra or jewelry that feels tighter than usual or leaves a dent or mark on the skin
  • A feeling of fullness in the affected area
  • A sensation of heaviness or fatigue in the affected area
  • An area of the skin that is red or warm to the touch

Our Multidisciplinary Team

  • Alphonse Taghian, MD, PhD
  • Barbara Lynn Smith, MD, PhD
  • Michelle Connolly Specht, MD
  • Krista Elliot, NP
  • Jean O'Toole, PT, MPH, CLT-LANA
  • Lauren Jammallo, BS
  • Cynthia Miller, BS
  • Melissa Skolny, MSHA
  • A Multidisciplinary Approach

    Breast cancer-related lymphedema can significantly decrease a patient's quality of life. Even the possibility of developing lymphedema may cause people to alter their lifestyle to prevent its occurrence.

    Our program's multidisciplinary team includes physicians, nurses, a certified lymphedema therapist, social workers and nutritionists working together to:

    • Ensure ongoing screening
    • Educate patients about risk factors, signs and symptoms
    • Provide optimal management

    If lymphedema is detected, we design an individualized treatment plan that focuses on physical therapy and takes into account three factors:

    • Stage of lymphedema
    • Patient goals
    • Body mass index (BMI)
    • Patient's General Medical Condition

    Through early detection and an individualized treatment plan, we strive to optimize management of lymphedema and minimize the burden it creates. If you think you are experiencing symptoms of lymphedema, please contact your healthcare provider

    What to Expect

    Prior to breast cancer surgery, we measure the volume of each arm with a Perometer, a device that uses digital technology to calculate size and volume. Testing with a Perometer is both non-invasive and faster than other screening methods. At subsequent visits, we compare each new measurement with the baseline measurements taken prior to surgery. We monitor for swelling to detect lymphedema. Since breast cancer patients are at lifelong risk for developing lymphedema, we generally perform follow-up measurements every three to seven months.

    For more information, please review our factsheet.

    About This ProgramThe Lymphedema Studies Program, part of the Gillette Center for Breast Cancer, launched in 2005 under the leadership of Alphonse Taghian, MD, PhD.

    A Leader in Prospective ScreeningWe prospectively screen for breast cancer-related lymphedema in newly diagnosed breast cancer patients so we can treat the condition in its earliest stages. Our services are incorporated into the care of all newly diagnosed breast cancer patients at the Massachusetts General Hospital Cancer Center. We have evaluated more than 2,500 breast cancer patients by measuring arm volume before and after breast cancer surgery.

    Research: a Program PriorityCurrently, our program is conducting a large, federally funded clinical trial on early detection and intervention for lymphedema in patients treated for breast cancer. The study evaluates the effectiveness of using compression garments to prevent or slow the progression of lymphedema. Patients will be fitted by a certified lymphedema therapist for compression garments. All our patients are welcome to enroll in this trial. Participation is voluntary.

    Current Mass General Clinical Trials Related to Lymphedema

     

    Additional Online Resources

    Breast cancer treatment, BMI, post-op swelling/lymphoedema (PDF)

    Download the National Institutes of Health report to see how doctors are using body mass index (BMI) to help diagnose breast cancer-related lymphedema.

    Screening and Measurement for Early Detection of Breast Cancer-Related Lymphedema (PDF)

    Download the National Lymphedema Network's report explaining the importance of early detection in breast cancer-related lymphedema.

    Obesity is a Risk Factor for Developing Postoperative Lymphedema in Breast Cancer Patients (PDF)

    Read a report discussing the association between obesity and increased risk of developing lymphedema after breast cancer surgery.

    Weight Lifting for Women at Risk for Breast Cancer–related Lymphedema (PDF)

    Download the Journal of American Medical Association's study about weight lifting for women at risk for breast cancer-related lymphedema.

    Weight Lifting in Women with Breast Cancer–related Lymphedema (PDF)

    Read more about weight lifting and lymphedema in this study from the New England Journal of Medicine.

    Lymphedema and Breast Cancer Fact Sheet (PDF)

    Download the Massachusetts General Hospital Cancer Center fact sheet to learn more about lymphedema. Discover the risks, causes, symptoms, treatment and preventative measures offered.

    Standardized Method for Quantification of Developing Lymphedema in Patients Treated for Breast Cancer (PDF)

    Doctors at Mass General are developing a simple and practical formula for quantifying breast cancer-related lymphedema. Download the report.

    Dr. Vodder School International

    The Dr. Vodder School offers training programs for health care professionals in manual lymph drainage and combined decongestive therapy.

    Klose Lymphedema Therapy Certification Courses

    Klose Training & Consulting, LLC offers certification courses in lymphedema certification and continuing-education courses for medical professionals.

    Lymphology Association of North America

    The Lymphology Association of North America (LANA) consists of medical professionals who create and implement a national certification standard to treat lymphology and lymphedema.

    Norton School of Lymphatic Therapy

    The Norton School of Lymphatic Therapy trains health care professionals in pathological treatments related to the lymphatic system.

    YWCA

    The YWCA offers support programs for breast cancer patients, such as the Pink Program.

    The Livestrong Foundation

    The Livestrong Foundation offers patients with breast cancer information and resources to manage their condition.

    Home Disconnect

    A home infusion pump may be part of your treatment plan. In some cases, you may have the option for disconnecting the chemotherapy from home. If this option applies to you, and you would prefer to disconnect from home, this instructional video will reinforce the teaching provided to you by your nurse in the Mass General cancer Center

    Screening for lymphedema with a Perometer

    Doctors at Massachusetts General Hospital Cancer Center are using a Perometer to detect breast cancer-related lymphedema.

    Breast cancer treatment, BMI, post-op swelling/lymphoedema (PDF)

    Download the National Institutes of Health report to see how doctors are using body mass index (BMI) to help diagnose breast cancer-related lymphedema.

    Screening and Measurement for Early Detection of Breast Cancer-Related Lymphedema (PDF)

    Download the National Lymphedema Network's report explaining the importance of early detection in breast cancer-related lymphedema.

    Obesity is a Risk Factor for Developing Postoperative Lymphedema in Breast Cancer Patients (PDF)

    Read a report discussing the association between obesity and increased risk of developing lymphedema after breast cancer surgery.

    Weight Lifting for Women at Risk for Breast Cancer–related Lymphedema (PDF)

    Download the Journal of American Medical Association's study about weight lifting for women at risk for breast cancer-related lymphedema.

    Weight Lifting in Women with Breast Cancer–related Lymphedema (PDF)

    Read more about weight lifting and lymphedema in this study from the New England Journal of Medicine.

    Lymphedema and Breast Cancer Fact Sheet (PDF)

    Download the Massachusetts General Hospital Cancer Center fact sheet to learn more about lymphedema. Discover the risks, causes, symptoms, treatment and preventative measures offered.

    Standardized Method for Quantification of Developing Lymphedema in Patients Treated for Breast Cancer (PDF)

    Doctors at Mass General are developing a simple and practical formula for quantifying breast cancer-related lymphedema. Download the report.

    Dr. Vodder School International

    The Dr. Vodder School offers training programs for health care professionals in manual lymph drainage and combined decongestive therapy.

    Klose Lymphedema Therapy Certification Courses

    Klose Training & Consulting, LLC offers certification courses in lymphedema certification and continuing-education courses for medical professionals.

    Lymphology Association of North America

    The Lymphology Association of North America (LANA) consists of medical professionals who create and implement a national certification standard to treat lymphology and lymphedema.

    Norton School of Lymphatic Therapy

    The Norton School of Lymphatic Therapy trains health care professionals in pathological treatments related to the lymphatic system.

    YWCA

    The YWCA offers support programs for breast cancer patients, such as the Pink Program.

    The Livestrong Foundation

    The Livestrong Foundation offers patients with breast cancer information and resources to manage their condition.

    Home Disconnect

    A home infusion pump may be part of your treatment plan. In some cases, you may have the option for disconnecting the chemotherapy from home. If this option applies to you, and you would prefer to disconnect from home, this instructional video will reinforce the teaching provided to you by your nurse in the Mass General cancer Center

    Cancer Center

    Gillette Center for Breast Cancer
    Yawkey Cancer Center, Suite 9A

    Phone: 617-643-1306
    Hours: Mon-Fri 8:00 am-4:30 pm

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