Fast FAQS: Introduction to Lymphedema

Patient Expert

Q. I've heard about "watching out" for lymphedema, but I'm not really sure what it is. Help!

A. Lymphedema is a buildup of fluid in your arm after you've had one or more lymph nodes removed, or sometimes as a result of radiation. Lymph nodes are hard-working little nodules clustered in various parts of your body whose job it is to filter harmful bacteria and other infections out of your lymph fluid. Lymph fluid, in turn carries white blood cells, and circulates around the body via lymph vessels, and the bloodstream. Bottom line, it's your lymph system that helps you fight infection; you need it.

When you have surgery on your breast, and one or more lymph nodes is removed to check for cancer, it affects the whole system on that side. Along with the nodes come some of the vessels; scar tissue blocks other vessels, and suddenly, the lymph system can't do its job as efficiently and effectively. (Sometimes radiation can cause this, as well.) The result? If other nodes don't "step up," swelling in the arm and upper chest: lymphedema. This swelling can range from "Gosh, why do my rings feel so tight today?" to "WOW, my whole arm is swelled up like a balloon!" But whatever the severity, it's something you need to deal with, not ignore.

The good news is, only 10% to 15% of women who've had surgery for breast cancer come down with lymphedema. The bad news is, you can get it anytime, including years later, long after you've finished your treatment. So it's something we all need to be aware of.

Q. What happens if I ignore it and just wait for the swelling to go away? Won't it just calm down in time?

A. OK, here's some more bad news: Lymphedema that is left untreated can potentially lead to cellulitis, an infection of the skin that can become severe very quickly. (Did you know your skin is the largest organ in your body? It's not just there to hold your insides together; it performs a number of important functions, so an infection is bad news.) Cellulitis needs to be treated with antibiotics; and in some cases, these drugs must be given intravenously, which means a stay in the hospital. Trust me; you don't want cellulitis, which means you don't fool around with lymphedema.

As for lymphedema just going away on its own: probably not. It's the sign that your system just isn't handling the trauma its undergone, and needs some help. Luckily, as the incidence of lymphedema becomes lower and lower, due to less and less invasive surgery, the treatment also becomes better and better. There are very few cases of the "elephant arm" that years ago used to be a terrifying side effect of breast cancer surgery. If you think you have lymphedema, see your doctor, and ask for treatment. Many health care facilities now have physical therapists trained specifically to treat lymphedema; one of these therapists can almost certainly help you get it under control, and hopefully even banish it completely.