Breast Cancer Survivors Swelling

Lymphedema may develop in one in five breast cancer survivors

(RxWiki News) Women who’ve lived through breast cancer often experience lingering effects from treatment. One of those effects is arm swelling. Researchers recently defined how often this swelling occurs, which women are most at risk and what can be done to help prevent the condition.

A new study found that about one in five women who’ve been treated for breast cancer will develop lymphedema — a swelling of one or both arms.

Tejal Patel, MD, an oncologist in Houston Methodist Cancer Center's Breast Oncology department and dailyRx Contributing Expert, says she doesn't see that many women developing lymphedema in her practice.

Staying physically active and maintaining an ideal weight are two ways to help prevent lymphedema, the researchers found.

"Try to get at least a few minutes of physical activity in every day."

Tracey DiSipio, PhD, from the Queensland University of Technology’s Institute of Health and Technology in Brisbane, Australia, led this study which aimed to identify the percentage of breast cancer survivors with lymphedema and risk factors for the condition.

With lymphedema, fluid collects and causes swelling, usually in the arm closest to the affected breast. Lymphedema can be painful and cause heaviness or tightness in the arm. The condition can decrease range of motion, interfere with daily living and affect a survivor’s overall self-image, leading to emotional distress.

For this study, the researchers reviewed and analyzed 72 different studies on lymphedema and found that the condition can develop up to two years following treatment.

After analyzing data from the other studies, the researchers concluded that 21.4 percent of women — or about one in five women — who have been treated for breast cancer will later develop lymphedema.

Lymphedema results from the removal of lymph nodes, which act like filters to remove harmful substances from the body. And lymph nodes are the first place breast cancer spreads. A procedure called a sentinel (closest to the tumor) node biopsy is performed to see if the cancer has started to spread.

If cancer is discovered in more than one or two lymph nodes, all of the axillary (underarm) lymph nodes may be surgically removed in an operation called an axillary lymph node dissection.

Results of this study showed that women who had an axillary lymph node dissection were four times more likely to have lymphedema than women who had undergone only a sentinel node biopsy.

Other risk factors for lymphedema include having had one or both breasts removed (mastectomy) or having had more than several lymph nodes removed during the sentinel node biopsy.

Additionally, women who were overweight or obese or physically inactive were at higher risk of lymphedema, the researchers found.

“In our practice [at Houston Methodist], we do not see 20 percent of patients developing lymphedema. This may be related to the aggressive referral to lymphedema physical therapy that each patient undergoing lymph node dissection receives,” said Dr. Patel, who was not involved in this study.

“One of the risk factors for lymphedema is lack of regular physical activity; therefore it is imperative that these patients get the proper training and roadmap for better function and prevention of lymphedema,” Dr. Patel said.

This study was published in a recent issue of The Lancet Oncology.

The National Breast Cancer Foundation, Australia funded the research and no competing financial interests were reported.

Review Date: 
August 13, 2013