Lymphedema is a worry for many women after breast cancer surgery. The reports of the risk and incidence vary enormously, and the truth is that no one seems to really know how many women encounter this problem. What we do know is that, once you have lymphedema, you always have it. There are certainly ways to reduce its impact, but it remains a chronic problem and concern.
The bottom line is that there is little to no absolute evidence about possible causes and we each have to make our own decisions that balance concern vs. quality of life. For example, one standard piece of instruction is to wear a "sleeve" on airplanes. Recent studies have contradicted this as necessary, but many women are still given this advice. I have known only one woman who developed lymphedema after a flight (from Boston to Seattle), and she took the trip two weeks after her breast surgery that included a full axillary node dissection. My non-medical summation would be that the real issue for her was how recent the surgery had been. Personally, I have taken a number of very long flights (12-15 hours) since having a full axillary node dissection (since that was the standard of care in 1993, long before sentinel node dissection was widely used) and never had a problem. Will I feel like an idiot if I suddenly develop lymphedema? Sure, but this has been my decision.
There is a lot of information on the website of the National Lymphedema Network: www.lymphnet.org
Here is a quote from a recent article re risk reduction advice that is given:
Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals
Ilsa Nielsen, Susan Gordon, Anita Selby
Breast cancer-related lymphoedema (BCRL) is a debilitating, distressing condition affecting approximately one in five breast cancer survivors (Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005;98:343-8). The evidence-base for breast cancerrelated lymphoedema risk reduction advice is scant and contradictory, with most studies in the area limited by small numbers, retrospective design and other methodological inadequacies. Current advice has the capacity to profoundly alter quality of life following treatment for breast cancer. Health professionals should review the risk reduction advice they provide to reflect the current understanding of aetiology and risk factors. Further research is required to provide more evidence for the content, to identify optimal methods of precautionary education delivery and to determine the effect of the advice on the patient's quality of life