Lymphedema is a potential side effect of breast cancer surgery and radiation therapy that can appear in some people during the months or even years after treatment ends.

Lymph is a thin, clear fluid that circulates throughout the body to remove wastes, bacteria, and other substances from tissues. Edema is the buildup of excess fluid. So lymphedema occurs when too much lymph collects in any area of the body. If lymphedema develops in people who’ve been treated for Breast cancer, it usually occurs in the arm and hand, but sometimes it affects the breast, underarm, chest, trunk, and/or back.

Why does lymphedema happen? As part of their surgery, many people with breast cancer have at least two or three lymph nodes removed from under the arm (sentinel lymph node biopsy), and sometimes many more nodes (axillary lymph node dissection). If the cancer has spread, it has most likely moved into to those underarm lymph nodes first because they drain lymph from the breast. Many people also need radiation therapy to the chest area and/or underarm. Surgery and radiation can cut off or damage some of the nodes and vessels through which lymph moves. Over time, the flow of lymph can overwhelm the remaining pathways, resulting in a backup of fluid into the body’s tissues.

If you already have lymphedema but don’t remember hearing much about it during breast cancer treatment, you’re not alone, says Dr. Marisa Weiss, chief medical officer of Breastcancer.org. "I can say from experience that the time right after diagnosis, when you are considering options and planning treatment, is a blur. When you are feeling so anxious and overwhelmed, it is hard to listen, understand, and decide. So even if lymphedema gets mentioned during this time, you may not remember it. Or it may not come up because the focus is really on getting you well. So if lymphedema does develop later on, it can feel like yet another insult to the body, one that many women weren’t fully prepared for. The good news is that women can learn how to manage it and lead normal lives."

Although there’s no way to know for sure whether you’ll develop lymphedema after breast cancer, you can help yourself by learning more about it. Know your risk factors, take steps to reduce your risk, and be aware of early symptoms. Left untreated, lymphedema can worsen and cause severe swelling and permanent changes to the tissues under the skin, such as thickening and scarring.

Adding to the frustration some people feel is the conflicting advice about how to prevent and manage lymphedema - perhaps you’ve encountered some of it! There’s still much more research to be done before we fully understand this condition. Also, many doctors don’t have a great deal of experience with lymphedema. Realize that you may need to take charge and find your way to an experienced lymphedema therapist.

Lymphedema Treatments
Today there are more options than ever for treating lymphedema, and most have demonstrated some effectiveness in research studies. Most studies done so far have looked at treatment plans that use a combination of approaches. More research is needed to say for sure which individual treatments are most effective, in what combinations, and in which situations. In the meantime, you and your lymphedema therapist have several options to consider.

Treatments such as sleeves, bandages, and pumps help lymph flow out of the arm, hand, trunk, or other body part affected by lymphedema. Others involve making lifestyle changes - such as skin protection, exercise, and losing weight - that are shown to help the lymphatic system. The degree, intensity, and length of your treatments will depend on how severe your lymphedema is. For example, mild lymphedema with minor swelling typically requires less treatment than a later-stage lymphedema with obvious swelling and fibrosis (scarring of the soft tissue). Even if your lymphedema is more advanced, there are good options for getting the swelling down and keeping it down.