Lymphedema is swelling that occurs due to the accumulation of lymphatic fluid in the arms, legs, or other parts of the body.
Closely associated with breast cancer, its presence in patients who have undergone surgery or treatment for this disease is above 20%.
Why does lymphedema occur?
The lymphatic system is a complex system consisting of several organs. (bone marrow, tonsils, thymus or spleen) and a network of lymphatic vessels.
It plays an important role in the immune system and its main functions are to collect the lymph that forms in the tissues and transport it into the bloodstream and act as a biological filter.
Lymph is a slightly yellowish liquid made up of water (90%) and several proteins that have passed from the bloodstream to the tissues.
This liquid has remains of dead cells, bacteria, malignant cells (in case of cancer) and cells in the blood, such as lymphocytes.
The lymph is purified and filtered by the lymph nodes (also called lymph nodes) before returning to the general circulation.
However, if this drainage system is clogged and fluid cannot escape, it will build upforming the so-called lymphedema.
How does lymphedema manifest itself? What are your symptoms?
Dr. Israel Puell, specialist in rehabilitation of the hospital Quironsalud Torreviejaexplains that lymphedema manifests itself as a “fluid accumulation that produces a marked increase in the circumference of the affected limb”.
Other symptoms are “heaviness, pain, reduced mobility, infections and poor wound healing”.
Who is at risk for lymphedema?
The most common causes of lymphedema are presence of tumors (cancer cells can block lymphatic vessels), cancer radiotherapy treatments, cancer surgery (in some cases, lymph nodes are removed to determine if the disease has spread) or presence of some tropical parasites.
There is also a small percentage of cases in which lymphedema it is associated with hereditary conditions whereby the lymphatic system does not develop or function properly.
lymphedema and breast cancer
Of 21% of patients undergoing surgery or mastectomy for breast cancer may have lymphedema.
According to the Spanish Cancer Association, the incidence of lymphedema in cases of breast cancer treated with armpit surgery to remove the nodes is 10%, a figure that it can be increased to 20-25% if the patient also received radiation therapy in the armpit.
Other factors that increase risk of lymphedema after breast cancer:
Postoperative infection.
Obesity.
Lack of mobility.
Sedentary life.
Excess movement or poorly performed movements (poorly performed isometric exercises, arm strengthening with excessive weight and without proper guidelines, etc.)
Use of clothing or jewelry that compresses.
How does lymphedema affect patients?
Dr. Carlos Puell explains that lymphedema affects the quality of life of patientshow “It can have serious consequences on the functional and psychosocial aspects of your life.”
This condition can also be associated with “Dermatological complications (mycosis, acute dermatitis, erysipelas, fibrosis / sclerosis) and with some shoulder pathologies (adhesive capsulitis, soft tissue injury, etc.)”.
Diagnosis and treatment of lymphedema in Quirónsalud Torrevieja
Volume enlargement and other arm alterations on the same side of breast cancer surgery can alert us to the presence of lymphedema.
It will be the oncologist who will perform a thorough clinical examination and request the appropriate tests, including a lymphangiogram (which is done by injecting counterstain into the lymphatic vessels and x-rays of the area) or lymphoscintigraphy.
Depending on the time of its appearance, lymphedema can be early (on many occasions it is post-surgical edema) the late (Swelling appears sometime after surgery, usually due to overload, infection, etc.).
Once the diagnosis is established, drug, surgical and / or complex physical therapy will be treated.
“Treatment is symptomatic”, adds Dr. Israel Puell, del Quirónsalud Torrevieja rehabilitation service.
“It is recommended to treat lymphedema when symptoms and a limb volume difference greater than 2 cm from the reference value are present. The goals of treatment are reduce volume, reduce symptoms and prevent progression and possible complications“.
The treatment of lymphedema in patients after breast cancer in Quirónsalud Torrevieja includes several actions in the field of rehabilitation.
“Complex physical therapy (CPT) is performed for 2-4 weeks. This therapy consists of the application of a manual lymphatic drainage or DLM (a massage technique that is applied to the skin and which follows the position of the lymphatic vessels) and the ‘application of a multilayer bandage (with low elasticity bandages that allow low pressure at rest and high pressure in motion). This bandage is worn continuously between one MLD session and the next. “
Once the swelling has stabilized, the “maintenance” phase is carried out.where custom-made elastic containment garments (sleeves) are used.
“The sleeves are placed once the edema has stabilized and the reduction phase is over, and their function is to maintain the volume reached”adds the head of rehabilitation of the Quirónsalud Torrevieja hospital.
rehabilitation of lymphedema also includes practice “Exercise regularly and take care of proper skin hygiene“.
In some cases, experts may recommend psychological treatment.
Is it possible to prevent lymphedema after breast cancer?
Dr. Israel Puell exposes some of them effective guidelines to reduce the risk of developing lymphedema later breast cancer surgerybetween them:
Postoperative measures in the immediate postoperative period: we recommend a reclined position of 45 degrees while lying in bed, in addition to keeping the limb raised with the help of pillows.
Personal hygiene and care measures: it is recommended to wash the area thoroughly and avoid moisture, compression and injury. It should also be taken into account that the patient is more prone to infections in that limb.
Kinesiotherapy: or what is the same, perform breathing and mobility exercises that promote lymphatic drainage of the area.
Request more information in the Quirónsalud Torrevieja Rehabilitation Service
