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, 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, and unfortunately
lymphedema of the breast/chest can occur. And the sentinel
nodes are not always located in the axilla.
Also, in this day of
TRAM flap or DIEP flap
reconstruction,
we are also seeing more and more breast/chest and/or
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.
