Lymphedema is swelling caused by fluid that collects in tissue under the skin. Clinical research coordinators discuss the Lymphedema Screening Program at Mass General and their current LymphVAX project related to COVID-19 vaccination.
What is Breast Cancer-related Lymphedema?
Patients who have undergone surgery or radiation therapy for breast cancer have greater risk of developing a form of swelling called lymphedema, a lymphatic system disease.
The lymphatic system collects extra fluid, as well as proteins and other substances, from the body's tissues. This fluid is known as lymph. If the flow of lymph in the body is blocked, fluid can collect in the fatty tissues under the skin. The resulting swelling is lymphedema.
Lymphedema can develop weeks, months or years after cancer treatment, preventing the lymphatic system from doing its job. The condition 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 breast cancer-related 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 feeling of heaviness or fatigue in the affected area
- An area of the skin that is red or warm to the touch)
Please note: Lymphedema symptoms may look similar to those associated with other medical conditions. Call your treatment team if you have any of these symptoms.
Screening for Lymphedema
Your treatment team will screen you for lymphedema before you start breast cancer radiation or surgery. This is so treatment can be started right away if you do develop lymphedema.
The team will begin the screening process by measuring the size and volume of your arms. Further measurements to monitor for signs of swelling are then taken during visits after surgery. Follow-up measurements should be taken every three to seven months. This is because breast cancer patients are at lifelong risk for developing lymphedema.
At Massachusetts General Hospital Cancer Center, a diagnosis of breast cancer-related lymphedema is made through a physical examination. During the exam, your doctor can look for signs of lymphedema, particularly lumps that could be swelling.
Following a diagnosis of breast cancer-related lymphedema, your care team will work with you to develop an individualized treatment plan that takes into account your:
- Stage of lymphedema
- Body mass index (BMI)
- Personal goals
- General health
While there is no cure for lymphedema, treatment can help minimize the burden you experience. In most cases, treatment focuses on physical therapy rather than medication. In working with a trained lymphedema therapist, you can learn to massage your arm, do helpful exercises and bandage your arm, if needed. Wearing a compression glove or sleeve during the day or at night may also be a treatment option.
Through early detection and the proper treatment plan, many lymphedema patients are able to maintain their daily lifestyle.
Breast cancer-related lymphedema cannot be prevented. However, you can reduce your risk of developing this condition through safely controlled exercise, maintaining an ideal weight and good skin care.
Taking steps like these can help guard against skin infections:
- Wash any cuts with soap and water
- Wear gloves while gardening, doing dishes or housework
- Protect yourself from insect bites
- Use skin cream to avoid chapped, dry or broken skin
- Use sunblock with an SPF of 30 or more to prevent sunburns
- Avoid scratches or bites from pets
- Be careful with sharp objects or edges
- Don't have your cuticles (the skin around your nails) cut during manicures or pedicures; push back the cuticles instead
- Choose a nail salon that is clean and uses sterile instruments; you can even bring your own instruments with you
- Avoid repeated punctures of the skin on the treated side (e.g. blood tests or finger sticks to check blood sugars)