Together, we can make the difference in Lymphedema

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When we hear of lymphedema as a result of breast cancer treatment, we usually think of lymphedema of the arm and hand.

In this day of sentinel lymph node biopsy, breast conserving treatment, skin sparing mastectomies and radiation, we are seeing more and more breast and chest lymphedema. 

When the sentinel nodes are removed, the first drainage of the breast/chest is disturbed. Unfortunately "edema" of the breast/chest can occur in the short term, sometimes causing pain (more common) and sometimes not.  This alone can cause lymphedema at a later time.

The addition of radiation stiffens the tissues around the remaining lymphatic vessels, further interrupting their ability to pump lymphatic fluid. The effects of radiation can continue for 18 months to 2 years (or longer) causing remodeling of scar tissue, which causes lymphedema to wax and wane during that time.

Lymphedema of the breast and trunk (present longer than ~ 3 months after treatment is finished) occurs in ~ 35% of cases according to the literature. However, because it is poorly tracked and documented, this number is probably much higher than the literature describes. 

Scar tissue left over from surgery and radiation further interrupts the draining lymphatics of the breast and chest wall.

So there are three reasons for lymphatic movement to be compromised: surgery, radiation and scar tissue. The risk increases with the amount of damage caused by each of these treatments.

Also, in this day of TRAM flap or DIEP flap reconstruction, we are seeing more chest/breast/truncal lymphedema.    Not only are the lymph nodes of the axilla disturbed/removed (whether you have had sentinel lymph node biopsy or full axillary dissection) but also the lymphatic vessels and drainage of the trunk has been cut and/or disturbed.

Women and men who have undergone a lumpectomy, mastectomy, with or without  reconstruction, are all at risk for breast/chest/truncal lymphedema.

Breast, chest and truncal lymphedema can occur with or without arm/hand lymphedema. 

Lymphedema in the breast/chest wall/trunk can be difficult to diagnosis, especially if the patient does not have lymphedema of the arm.  Breast, chest and truncal lymphedema present differently than in the arm.  Often intense pain, tenderness and a sense of fullness and hotness, possibly swelling, possibly not.  There may be a sense of fullness in the armpit, back, side, breast and along the scar tissue.  Although post-operative swelling is normal, the tell tale sign of breast/chest/truncal lymphedema is its persistence.  It does not resolve on its own over time.  For patients who have undergone lumpectomy or reconstruction the affected breast may be larger than it was before treatment.  Many patients will also report discomfort with movement and activities of daily living.  Visible indentations from bra straps or seams may be seen on the affected side, but not on the other side.  Other signs include a thickening of the skin or hard spots of fibrosis on the breast, chest wall or back.  


Unfortunately, our doctors are not often aware of these special areas of lymphedema.  If you feel that swelling in your breast/chest/trunk area may be lymphedema, please ask your healthcare provider for a referral to a qualified lymphedema therapist.  If your doctor says it is just post-operative swelling, but the swelling continues in your chest, breast, trunk, do not wait.  Insist on a referral to a qualified lymphedema therapist. 

While the basic treatment for lymphedema in these areas consists of Manual Lymphatic Drainage Massage, Breast Compression, Skin Care, Exercise and Patient Education, there are some special challenges to treating breast/chest/truncal lymphedema, and we have included these pages of information on garments that are helpful in treating this "special" type of lymphedema.

Please browse through these categories.  Working with your therapist, we are sure you will find some solutions to your chest/breast/truncal lymphedema problems.

Also, please read these very informative articles on breast/chest/truncal lymphedema:

Lymphedema Affecting the Breast and Trunk By Joachim Zuther, on October 5th, 2011

Breast and Trunk Oedema after Treatment for Breast Cancer Journal of Lymphoedema, 2006, Vol 1, No 1.


Breast Binders/Men and Women

Compression Camisoles/Shapewear for Women and Men 



Compression Bras

Sports Bras


Swell Spots™ and Foam Padding


Page Last Modified 09/29/2015

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