The lymphatic system consists of many vessels that carry lymph fluid throughout the body. Lymph is a clear, colorless fluid containing water and a few blood cells; it originates in many organs and tissues. The lymphatic system is part of your immune system. It helps to protect and maintain the fluid environment of the body by filtering and draining lymph and waste products away from each region of the body.
Often during a lumpectomy or mastectomy, some or all of the lymph nodes under the arm may be removed. The lymph nodes under the arm (also called the axillary lymph nodes) drain the lymphatic vessels from the upper arms, the majority of the breast, the neck, and the underarm regions. The lymph nodes help to filter excess fluid, bacteria, and by-products of infections.
Whenever the normal drainage pattern in the lymph nodes is disturbed or damaged (as often happens during surgery to remove the lymph nodes), severe swelling of the arm may occur. Radiation may also damage lymph nodes and cause swelling of the arm. This swelling, caused by an abnormal collection of too much fluid, is called lymphedema. The swelling can be noticed in the arm, chest, and breast area on the side of surgery.
When the lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema for the rest of her life. Lymphedema may occur immediately following surgery, or months or years later. Not every woman who has a mastectomy will experience lymphedema.
There are several types of lymphedema. The acute, temporary, and mild type of lymphedema occurs within a few days after surgery and usually lasts a short period of time. The acute and more painful type of lymphedema can occur about four to six weeks following surgery. However, the most common type of lymphedema is slow and painless and may occur 18 to 24 months or more after surgery.
There are no specific diagnostic tests for lymphedema. The doctor will complete a medical history and physical examination. The medical history may include questions regarding the following:
The main symptom of lymphedema is swelling of the affected arm. The degree of swelling may vary. Some people may experience severe swelling (edema) with the affected arm being several inches larger than the other arm. Others will experience a milder form of edema with the affected arm being slightly larger than the other arm.
In addition to swelling of the affected arm, the following are the most common symptoms of lymphedema. However, each individual may experience symptoms differently. Symptoms may include:
The symptoms of lymphedema may look a lot like other medical conditions. Consult a doctor for a diagnosis.
Treatment for lymphedema depends on the severity and extent of the condition. Prevention and controlling lymphedema play an important role with this condition since there is no cure.
Treatment may include the following:
Breast cancer patients who perform good skin care and exercise properly after mastectomy are less likely to develop lymphedema.
Protection of the arm on the side of the surgery is very important after breast surgery. Poor drainage of the lymphatic system may cause that arm to be more susceptible to infection and less sensitive to extreme temperatures. People who have had surgery to remove lymph nodes in the arm pit should be aware of those activities that put too much pressure on the affected arm. Protective measures to avoid injury and infection include:
Talk to your doctor about what you can do to try to prevent lymphadema from happening to you. If lymphadema does develop, let your doctor know right away. There are things you can do to try to keep it from getting worse.
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