Did you know, 1 in 8 females are expected to be diagnosed with breast cancer in their lifetime?1
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During the course of breast cancer treatment, often breast tissue is removed (mastectomy and lumpectomy), and lymph nodes are removed in the armpit (sentinel lymph node dissection, and axillary lymph node dissection). Lymphedema is a frequent complication that arises from removal of lymph nodes.
What is lymphedema? Breast cancer-related lymphedema (BCRL) affects approximately 20% of women that have undergone treatment for breast cancer.2 BCRL most often affects the arm, hand, and chest wall. BCRL develops due to a disruption in the lymphatic system. When the lymphatic system is dysfunctional it impacts the ability of the lymphatic vessels to drain lymph fluid effectively. With the ability to drain lymph fluid decreased, the hand, arm, or chest wall may appear swollen. This swelling is called lymphedema.
Risks of developing breast cancer-related lymphedema?
- Undergoing axillary lymph node dissection surgery
- Undergoing radiation therapy to lymph nodes
What are the signs of breast cancer-related lymphedema?
- A feeling of heaviness in the arm and/or hand
- Swelling into the hand, arm, or breast that may or may not reduce with elevation
- Decreased range of motion into the shoulder arm, hand, or fingers
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How can physiotherapy help?
BCRL is a chronic health condition that can be managed with use of compression garments. Physiotherapists who are also trained as certified lymphatic therapists (CLT’s) can complete a thorough assessment of the arm including taking circumferential measures to track the volume of fluid. Often treatment involves a reduction phase (using hands-on techniques such as manual lymphatic drainage, as well as bandaging to compress the limb) and a maintenance phase (getting fit for a compression garment that is worn during the day). Also, exercise is an important component of long-term management. A slow, progressive program with correct technique has even shown to have a preventative effect.3
If you have had breast cancer and would like an assessment, please contact the Welcome Back Clinic today to book with our physiotherapist and certified lymphatic therapist.
1. Canadian Cancer Statistics Advisory Committee. Canadian Cancer Statistics 2023.
2. McNeely ML, Harris SR, Dolgoy ND, Al Onazi MM, Parkinson JF, Radke L, Kostaras X, Dennett L, Ryan JA, Dalzell MA, Kennedy A, Capozzi L, Towers A, Campbell KL, Binkley J, King K, Keast D. Update to the Canadian clinical practice guideline for best-practice management of breast cancer-related lymphedema: study protocol. CMAJ Open. 2022 Apr 12;10(2):E338-E347. doi: 10.9778/cmajo.20210038. PMID: 35414596; PMCID: PMC9007443.
3. Hasenoehrl T, Palma S, Ramazanova D, Kölbl H, Dorner TE, Keilani M, Crevenna R. Resistance exercise and breast cancer-related lymphedema-a systematic review update and meta-analysis. Support Care Cancer. 2020 Aug;28(8):3593-3603. doi: 10.1007/s00520-020-05521-x. Epub 2020 May 15. PMID: 32415386; PMCID: PMC7316683.