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Lymphedema

Posted 4/1/2013

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  Lymphedema, arm or hand swelling after removal of axillary lymph nodes, is a major concern for many women. The risk is higher for women who have a full axillary dissection, rather than "just" a sentinel node dissection, and higher still for women who had the larger surgery and then radiation therapy. However, even for those women (and I am one), the actual incidence is rather low. It seems impossible to pin down any well documented or exact figures re the rate of lymphedema; the reported numbers vary so widely that it is almost funny. What is not disputed is that this is a serious problem for affected women.

  Once it happens, lymphedema never goes completely away. It can often be well controlled with combinations of PT and massage and wearing a sleeve or a glove. But it is there, and can be anything from a slight discomfort to a really swollen arm which makes finding clothes difficult and brings a great deal of distress and embarrassment.

  If you are dealing with lymphedema, my strongest advice is to find a PT who is skilled in its treatment. The right PTs know more about this than anyone else. There is also a lot of information on the National Lymphedema Network ( http//lymphnet.org ). Another good source of information is Living Beyond Breast Cancer's very complete guide than can be downloaded or ordered in paper: http://www.lbbc.org/Understanding-Breast-Cancer/Guides-to-Understanding-Breast-Cancer/Guide-to-Understanding-Lymphedema

  This is an interesting article from Lancet Oncology that nicely straddles the line between a medical article and patient education. Here is the beginning and then a link:

Arm lymphoedema after breast cancer

Breast-cancer-related lymphoedema is a substantial

Breast-cancer-related lymphoedema is a substantial

problem in women after they have undergone breast

cancer treatment. Despite the introduction of breastconserving

surgery and minimal lymphatic intervention

(eg, sentinel-lymph-node biopsy [SLNB]), incidence

rates remain disappointingly high. In The Lancet

Oncology, Tracey DiSipio and colleagues1 report the

fi ndings of their systematic review and meta-analysis

in which they shown that roughly one in fi ve women

with breast cancer will develop arm lymphoedema.1 The

incidence was four times higher in women undergoing

axillary lymph-node dissection compared with those

who received sentinel-lymph-node biopsy.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70097-4/fulltext

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