Lymphedema
Medical Author: Melissa
Conrad Stöppler, MD
Medical Editor: William C. Shiel,
Jr., MD, FACP, FACR
Lymphedema and Breast Cancer Treatment
Therapy May Relieve Breast Cancer Surgery Complication
WEDNESDAY, Jan. 13 (HealthDay News) -- A common complication of breast cancer surgery can be prevented or reduced if patients receive physical therapy, including massage and shoulder exercises, soon after their operation, a new study suggests.
Secondary lymphedema -- caused by damage to the lymphatic system during treatment -- results in fluid retention and arm swelling. It affects 71% of patients within 12 months of breast cancer surgery and can cause disfigurement, anxiety, depression and emotional distress.
Maria Torres Lacomba, a professor of physiotherapy at Alcala de Henares University in Madrid, Spain, and colleagues selected 120 women who had breast cancer surgery involving removal of lymph nodes and divided them into two groups -- an intervention group that received early physiotherapy and education, and a control group that received education only. Both programs lasted three weeks and the patients were followed up four weeks after surgery and again three, six and 12 months after surgery.
Read more on lymphedema and breast cancer treatment »
SOURCE: HealthDay News
What is lymphedema?
Lymphedema is a condition characterized by swelling in one or more
extremities that results from impaired flow of the lymphatic system.
The lymphatic system is a network of specialized vessels (lymph vessels)
throughout the body whose purpose is to collect excess lymph fluid with
proteins, lipids, and waste products from the tissues. This fluid is then
carried to the lymph nodes, which filter waste products and contain
infection-fighting cells called lymphocytes. The excess fluid in the lymph
vessels is eventually returned to the bloodstream. When the
lymph vessels are
blocked or unable to carry lymph fluid away from the tissues, localized swelling
(lymphedema) is the result.
Lymphedema most often affects a single arm or leg, but in uncommon situations
both limbs are affected.
- Primary lymphedema is the result of a design flaw of
the lymph vessels and is a rare, inherited condition.
- Secondary lymphedema
results from an identifiable damage to or obstruction of normally-functioning
lymph vessels and nodes.
- Worldwide, lymphedema is most commonly caused by
filariasis (a parasitic infection), but in the U.S., lymphedema most commonly
occurs in women who have had breast cancer surgery, particularly when followed
by radiation treatment.
It has been estimated that worldwide, there are 140-250 million people
affected by lymphedema.
What causes lymphedema?
Primary lymphedema causes
Primary lymphedema is an abnormality of an individual's lymphatic system and
is likely present at birth, although symptoms may not become apparent until
later in life. Depending upon the age at which symptoms develop, three forms of
primary lymphedema have been described. Most primary lymphedema occurs without
any known family history of the condition.
- Congenital lymphedema is evident at birth, is more common in females, and
accounts for 10%-25% of all cases of primary lymphedema. A subgroup of people
with congenital lymphedema has a genetic inheritance (in medical genetics termed
"familial sex-linked pattern"), which is termed Milroy disease.
- Lymphedema praecox is the most common form of primary lymphedema, making up
65%-80% of cases. It is defined as lymphedema that becomes apparent after birth
and before age 35 years and symptoms most often develop during
puberty.
Lymphedema praecox is four times more common in females as in males.
- Primary lymphedema that becomes evident after 35 years of age is known as
Meige disease. It is less common than congenital lymphedema and lymphedema
praecox and accounts for 10% of cases of primary lymphedema.
Secondary lymphedema causes
Secondary lymphedema develops when a normally-functioning lymphatic system is
blocked or damaged. In the U.S., breast cancer surgery, particularly when
combined with radiation treatment, is the most common cause. This results in
one-sided (unilateral) lymphedema of the arm. Any type of surgical procedure
that requires removal of regional lymph nodes or lymph vessels can potentially
cause lymphedema. Surgical procedures that have been associated with lymphedema
include vein stripping,
lipectomy, burn scar excision, and
peripheral vascular
surgery.
Damage to lymph node and lymph vessels, leading to lymphedema, can also occur
due to trauma, burns, radiation, infections, or compression or invasion of lymph
nodes by tumors.
Worldwide, however, filariasis is the most common cause of lymphedema.
Filariasis is the direct infestation of lymph nodes by the parasite Wuchereria
bancrofti. The disease is spread among persons by mosquitoes, and affects
millions of people in the tropics and sub-tropics of Asia, Africa, Western
Pacific, and parts of Central and South America. Infestation by the parasite
damages the lymph system, leading to swelling in the arms, breasts, legs, and,
for men, the genital area. The entire leg, arm, or genital area may swell to
several times its normal size. Also, the swelling and the decreased function of
the lymph system make it difficult for the body to fight infections. Lymphatic
filariasis is a leading cause of permanent disability in the world.
Next: What are the symptoms of lymphedema? »
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