Lymphedema

Lymphedema occurs when too much lymph collects in any area of the body.  Lymph is a clear thin fluid that circulates throughout the body to remove wastes, bacteria, and other toxins from the body’s tissues; and edema is the buildup of excess fluid.  Lymphedema is a potential side effect of breast cancer surgery and radiation therapy that can appear in some people during the months or sometimes years after treatment ends.
If lymphedema develops in people who’ve been treated for breast cancer, it usually occurs in the arm and hand, and sometimes it affects the breast, underarm, chest, trunk, and/or back
Many women with breast cancer have had at least two or three lymph nodes removed under the arm– depending upon which procedure as done.  If you’ve had a sentinel lymph node biopsy they’ve probably removed two or three nodes, but if you’ve had an auxillary lymph node dissection, the number can be significantly higher.  If the cancer has spread, it has most likely moved into to those underarm lymph nodes first because they drain lymph from the breast.   Surgery and radiation can cut off or damage some of the nodes and vessels through which lymph moves, and over time, the flow of lymph can overwhelm the remaining path ways, and the result is a backup of fluid into the body’s tissues.
Doctors believe that when the lymph system is disrupted by breast cancer treatments, the body compensates and adapts by finding another way to get rid of toxins, extra fluids, and proteins.
With fewer lymph nodes as a result of breast cancer, the proteins and wastes do not get filtered out of the lymph as efficiently as they once did.  Gradually, waste and fluid can build up in the tissues of the arm, hand, breast, chest, or trunk.  One or more of these areas may be affected. The result is typically mild lymphedema, which can get worse if it’s not treated.  Typically, with those who develop lymphedema, the symptoms generally appear within 3 years after surgery– although many cases appear 3-5 years after treatment.  (There aren’t longer term studies to estimate the risk after five years, but there are existing cases of lymphedema developing many years or even decades after treatment.)
Sometimes, first symptoms are sometimes triggered by a specific event, such as overuse of or injury to the arm.  If your lymphatic system is already having a hard time keeping up with the processing of fluids and toxins, a single event that sends more blood pumping through your arm than usual can trigger the body into lymphedema.  More blood means more fluid in the tissues, which also means more lymph entering the lymphatic system.  Even a cut, even a very small one,  allows bacteria to get into the hand or arm.  The lymph drains to the underarm lymph nodes that are responsible for straining out the bacteria and setting your body’s immune system into action. But fewer nodes are now available to do this work, so the immune response is slower. The bacteria have the chance to start multiplying in the lymph fluid — a perfect environment because it’s filled with nutrients they can thrive on.  The cut gets infected and the lymphatic system is even more overwhelmed.  The lymph has so much debris in it that it starts to clog the system. The fluid can’t get where it needs to go and starts pooling in the tissue.