Lymphedema is the build-up of fluid in soft body tissues, which results in tissue swelling. The lymph system is a network of lymph vessels, tissues, and organs that carry extra fluid from your cells/tissues (aka lymph) throughout the body. If this lymph is not able to flow in the body how it should, there is swelling, and lymphedema is caused¹.

There are two forms of lymphedema: primary and secondary. Primary is rare, only affecting approximately 1 in 100,000 people, and is a congenital condition. Most often due to a genetic mutation, it causes a malformation of the lymphatic system. Secondary lymphedema is due to an injury or obstruction to the lymphatic system, most often caused by an infection or from cancer treatments. Breast cancer is the most common cancer associated with secondary lymphedema in developed countries⁴.

Lymphedema most commonly affects the arms and legs but can occur in other areas of the body such as the chest wall, abdomen, neck, and genitals².  If severe, lymphedema can even affect the ability to move the affected limb, increase the risk of skin infections and sepsis, and even lead to skin breakdown.

Signs that lymphedema is present typically include swelling of one or both arms or legs, as well as the feeling of heaviness or tightness in the area, a restricted range of motion in that limb, infections of the area, and/or thickening of the involved skin¹.

While lymphedema is commonly caused by cancer and cancer treatments, it can also result from any type of issue that blocks the drainage of lymph fluid. If due to breast cancer and its treatment, common risks are treatment involving removal of or radiation of lymph nodes, infection after surgery, if you had a higher stage cancer in the past, being overweight/obese  and having a tumor that blocks the lymph ducts or vessels of the neck, chest, underarm, pelvis, or abdomen².

Lymphedema is classified into stages based on severity, being 0 to 3. Stages 0 and 1 are considered reversible, and through early diagnosis and treatment, the recovery to a normal volume and normal skin status of limbs can be possible. However, stages 2 and 3 are considered irreversible, and tissue hardening/thickening (fibrosis) progresses and cannot return to normal skin. This makes early detection and early treatment crucial.

Breast cancer patients are at a higher risk of getting lymphedema if they had all or part of their breast removed as well as the lymph nodes in their underarm. Anywhere from 5-17% of women who had a biopsy of the sentinel lymph node (first lymph node that cancer cells are spread from a tumor) develop lymphedema, and upwards of 20-53% of women develop it who have lymph nodes dissected from the underarm. This is an even higher percentage if they also receive radiation to the breast, chest, and underarm area³.