Lymphedema is a relatively obscure topic, even in the healthcare community. In the absence of direct knowledge, patients may not understand their symptoms. Unfortunately, not all doctors understand them either. In our office at Keck Medicine, we like to educate patients about lymphedema and what it may mean for them after their accurate diagnosis. Here, we answer some of the common questions people have about their symptoms and their health.
What is lymphedema?
Lymphedema is a chronic disease in the lymphatic system. The lymphatic system is involved in the vital function of fluid transport in the body. It is an aspect of the immune system that mobilizes infection-fighting cells when necessary. In addition to escorting white blood cells through the body, the lymphatic system also processes toxins and wastes. It consists of several nodes, vessels, and tissues. These can be affected by various factors, diminishing the overall function of the system.
There are two types of lymphedema, a condition that results in profound swelling in one or more body parts. Primary lymphedema may be inherited. Secondary lymphedema is a condition that occurs as a result of trauma, infection, radiation, and the removal of lymph nodes during cancer treatment.
I had lymph nodes removed but was not told about the risk of lymphedema. Why?
This is a frustrating experience for patients, understandably. It is unfortunate that many doctors are not fully aware of and educated about the lymphatic system and the conditions that may arise within it. While educational initiatives are being developed around the country, the matter of informed decision-making does still sometimes fall on individual patients. In this instance, patients who are aware of the causes and risks of lymphedema, or who experience this condition after surgery, can be their doctors’ best teachers.
I have survived breast cancer with lymph node dissection. Am I at risk of lymphedema?
Over time, as technologies have improved, the risk of lymphedema after breast cancer surgery involving lymph node dissection has decreased. Where this risk used to sit at 50%, it now sits at a lifetime risk of 15 to 25%. The risk is only about 6% for patients who have undergone sentinel node techniques alone (without radiation).
How does surgery affect my risk of lymphedema?
Some surgical procedures, particularly as a part of cancer treatment, involve the removal of various lymph nodes. Studies correlate the risk of lymphedema with the number of lymph nodes that are removed. This is because the body relies on all of its nodes to adequately move fluid throughout the body. Removal of lymph nodes disrupts this flow and can result in a blockage and buildup of fluid. Sentinel node technique is typically limited to no more than 4 lymph nodes. The correlated risk of lymphedema is only 6%.