Lymphedema after Breast Cancer and its Treatment

Abstract

Lymphedema (LE) is a chronic and progressive condition which is an abnormal retention of protein-rich fluid in the interstitial space because of inadequate lymphatic drainage. One of the most important complications of breast surgery is LE that can occur in the arm, hand and trunk. The incidence of breast cancer associated LE is reported 6-30%. The most important risk factors of LE are the type of axillary surgery and amount of chemotherapy and/or radiotherapy exposure after surgery. Recent studies showed that sentinel lymph node biopsy replaces axillary lymph node dissection in breast cancer treatment. For diagnosis of LE; clinical properties such as the unilateral or asymmetric character of edema, normal skin color, positive Stemmer sign, increased density of edema and extremity pain should be considered. After diagnosis, assessment of the patient includes obtaining information about anamnesis, physical tests, metastasis and risk of deep vein thrombosis. Treatment of the condition can be summarized under the topic of medical treatment, surgery and physiotherapy. Complex Decongestive Therapy (CDT) is accepted as the golden standard for LE treatment. CDT concept consists of four basic components (manual lymph drainage, skin care, compression treatment, therapeutic exercise) and two phases. Finally it should not be forgotten and should be learned that LE is a chronic condition that needs lifelong care. In this review; incidence, risk factors, approaches for protection of this factors, assessment methods and therapy options for LE are have been discussed.

Keywords

• lymphedema
• breast cancer
• physiotherapy
• multimodal treatment