Lymphoedema

Lymphoedema is rare, but you can be diagnosed with lymphoedema at any time following surgery or radiation treatment for breast cancer. It is important that your breast cancer specialist, nurse or GP makes this diagnosis. A specialised lymphoedema therapist makes all the difference. The sooner you are assessed and start treatment, the better the outcome. 

Lymphoedema therapists work in public or private clinics, talk to your breast cancer team for a referral or look at this list of private clinics. 

Lymphoedema develops when too much protein-rich fluid (lymph) accumulates in the tissues. When the lymphatic drainage system is damaged, usually due to surgery or radiation treatment, it can't transport the fluid out of the tissues and return it to the bloodstream. This causes swelling, which can become permanent if left untreated. It might also lead to skin infections and cellulitis.

Lymphoedema can develop within months of treatment or years later. The onset is usually gradual.

Lymphoedema is a progressive, chronic condition that develops in stages:

• Stage 0   Swelling isn't obvious, even though the lymphatic system has been damaged
• Stage I    In this early stage, lymph fluid accumulates in the tissues, causing swelling that goes down with elevation. There may be some "pitting" (an indentation that remains after pressure is applied to a small area)
• Stage II    Elevating the area doesn't reduce the swelling and pitting is obvious
• Stage III   The tissue is hard and no longer pits. The overlying skin thickens, gradually becoming discoloured and increased fat deposits develop. At this stage the affected area is usually very swollen and the swelling is irreversible

It’s important to know the early signs and symptoms of lymphoedema:

• Swelling of the arm, hand, breast or trunk. Jewellery or clothing may feel tighter than usual.
• Infection
• Aching, heaviness, stiffness on the affected side or limitation of movement
• Tightness or temperature changes to the affected area of the body.
• Swelling can be more obvious at the end of the day and may be aggravated by heat, overuse and prolonged inactivity.

If diagnosed and treated early, lymphoedema can be controlled and reduced. Early treatment can prevent infection, improve range of movement and enhance your wellbeing.

Risk factors:

• The extent of surgery, lymph node removal, radiation treatment
• Skin infections on or near the affected area
• Injury such as sprains, fractures, cuts or wounds on the affected side
• Obesity and immobility
• Constriction, for example from tight clothes or jewellery.
• Exposure to excessive heat including sunburn.

Learn more about lymphoedema after breast cancer

In New Zealand the current treatment for lymphoedema is based on the five “cornerstones” of care:

• Light touch massage
• Compression bandages or garments
• Special care of the limb/area
• Exercise
• Medical taping.

• Visit Lymphoedema NZ to find out more about lymphoedema therapy in New Zealand
• Head to the Australasian Lymphology Association website
• For lymphoedema support groups in New Zealand, visit the Lymphoedema Support Network

If you are worried about lymphoedema and need more information contact our nurses