Mary had some time to digest the breast cancer diagnosis she certainly did not want to hear, but also wasn’t one hundred percent surprised when it was confirmed. Her family had a history of breast cancer and a favorite aunt, of course, had a terrible time recovering from surgery and treatment many years ago. What is Lymphedema? What Mary’s aunt experienced years ago is called lymphedema. Immediately after surgery, it’s common to experience some swelling or tingling that can affect the arm, however the symptoms should resolve very quickly. That is in a matter of a few days. If lymphedema does occur, by radical axillary surgery, it can vary from mild swelling and a bit of heaviness to an arm that is significantly swollen. In addition to extensive lymph node surgery, obesity is a major factor for lymphedema with morbidly obese women at greater risk.
While lymphedema is not common, it is a common concern for all women, particularly when lymph nodes are removed. When lymph nodes are removed, the lymph vessels that carry the lymph fluid away from the arm can be disrupted and lymph fluid then collects in the arm to cause swelling.
Fortunately, advancements in the treatment of most types of breast cancers have lowered the occurrence of lymphedema dramatically by lowering the number of lymph nodes that need to be removed. In the past, it used to common practice to perform an “axillary lymph node dissection” during breast cancer surgery to remove all the lymph nodes, but up to forty percent of women would develop Lymphedema with this procedure.
What can be done to reduce the risk of lymphedema? So how can we reduce lymphedema while not sacrificing the probability of eradicating the cancer? In steps the Sentinel Lymph Node Biopsy. Over the past fifteen years, this has become the recommended procedure for evaluating cancer in the lymph nodes rather than the complete axillary lymph node removal. The sentinel lymph node, which is the key lymph node or the first lymph node that will receive the cancer cells should they spread out of the breast to the lymph nodes. And if only this lymph node is removed, it lowers the risk of lymphedema from forty percent to virtually zero, while still providing, in today’s day and age, a more intense analysis of it, accurate information of the degree of breast cancer in the axilla or under the arm. If the sentinel lymph node detects cancer cells, they are treated with radiation rather than more surgery. The beauty of this is that the effectiveness to which radiation controls the cancer and the risk of recurrence is the same as with radical surgical removal but with almost no risk.
Now knowing that there were factors here within her control to avoid lymphedema and the surgical procedures for breast cancer had advanced beyond complete lymph node removal, our patient Mary is much more optimistic about her surgery with no arm swelling.