Lymphedema

Lymphedema is an internal condition caused by damaged or removed lymph nodes due to subsequent medical issues, trauma, or weight problems. These compromised or nonexistent nodes prevent the lymphatic system from draining properly, resulting in excess lymph fluid and swollen limbs. The swelling can also occur in the face, neck, trunk, abdomen, and/or genitals.

If you suspect you may be dealing with lymphedema, you must schedule an evaluation with a physician. A physician will conduct a physical assessment and review your symptoms, lifestyle, and medical history. You may also be referred for additional tests that enable your physician to visualize your lymphatic system before making an official diagnosis.

The lymphatic system consists of valves and pipes. Lymphatic fluid manages the cells in the body, collecting bacteria and harmful cells and transporting them through the system to the nodes. The nodes determine whether white blood cells should be sent to fight off damaging bacteria or cells or whether the lymphatic fluid can continue circulating.

The lymphatic system is an immune system function. Lymphatic fluid plays an integral role in triggering the mobilization of infection-fighting white blood cells when harmful bacteria or cells are detected. As such, damaged or nonexistent lymph nodes equate to a compromised inner surveillance system, making a person more susceptible to infection and illness.

Lymphedema is divided into two categories: primary and secondary. Primary lymphedema is considered a hereditary or genetic malformation or malfunction of the lymphatic system. Secondary lymphedema is trauma-induced, caused by accidents, injury, surgery, medical treatment, such as breast cancer treatment, or weight problems, including obesity.

Primary lymphedema cannot be prevented as it’s tied to genetics. Secondary lymphedema is caused by trauma and is often associated with subsequent medical procedures. To mitigate the risk of lymphedema, many surgical oncologists are conducting fewer lymph node dissections and solely removing sentinel nodes to deter its development. However, there is no proven method to prevent lymphedema entirely.

Lymphedema symptoms vary. Depending on the severity of the condition, the symptoms range from minor and virtually undetectable to life-altering. Lymphedema symptoms include but are not limited to:

• Swelling in any part of the limbs
• General tight or heavy sensation
• Discomfort, aching, and restricted range of motion
• Recurring infections
• Thickening/hardening of the skin (fibrosis)

When lymphedema symptoms are detected and addressed in the early stages, patients may be able to successfully resolve them. However, without early intervention, lymphedema is progressive. For the majority of patients, lymphedema symptoms cannot be fully eradicated, resulting in a sustained diagnosis that requires continuous medical support.

Breast cancer survivors who have undergone axillary lymph node dissection used to be at 50% risk of developing lymphedema. However, that number has progressively decreased. The risk of lymphedema development has lowered to approximately 15-25% and only 6% when surgery relies solely on sentinel node techniques without radiation.