Breast Cancer and Lymphedema
What You Need to Know
by Julie Berrett-Abebe, MSW, LICSW, Corinne Holbrook, MSW,LICSW, Jean OToole, PT, MPH, CLT-LANA, and Tara A Russell, MPH
Scars from surgery, hair loss, and other side effects from treatments can affect a cancer survivor’s sense of emotional well-being. For breast cancer survivors, a particularly concerning possible side effect is lymphedema. Lymphedema associated with breast cancer commonly presents as a swelling or tightness in the arm, breast, or along the chest. This physical change can have a significant effect on a cancer survivor’s quality of life. Because many women are fearful that they may develop lymphedema, they may alter or avoid activities. In actuality, many breast cancer survivors do not develop lymphedema.
In order to manage the worry you may experience about developing lymphedema, you might find it helpful to understand the risk factors. Well-supported research identifies the following lymphedema risk factors for breast cancer survivors:
- surgery to the lymph nodes around the breast and underarm,
- radiation to the lymph nodes, and
- being overweight.
Although you may have more than one of these risk factors, it is important to remember that each of these only increases the chances of developing lymphedema and does not guarantee you will develop it. To gain a better understanding about your risk of lymphedema based on the type of treatment you received, talk to your medical team.
If you do develop lymphedema, it’s important to bear in mind that it is not your fault. Swelling, like other physical side effects from cancer treatments, happens to many survivors. There is still much to learn about why lymphedema occurs, but medical professionals do know that when it does occur, lymphedema can have a profound effect on the way individuals think and feel about themselves.
Lymphedema associated with breast cancer commonly presents as a swelling or tightness in the arm, breast, or along the chest.
The following are practical tips to help you cope with lymphedema after breast cancer:
- Go easy on yourself. This is hard.
- Stay active and maintain a healthy body weight. Try stretching, walking, swimming, yoga, or Tai Chi.
- Listen to your arm. With any activity, be gradual and don’t push yourself more than you feel able to.
- Develop a sense of balance and perspective. Remember the challenges you have already overcome.
- Wear clothes that make you feel good about yourself.
- Talk about your feelings with people who will listen and support you. Find out if there are any breast cancer or lymphedema support groups in your area.
Talk with your medical team about any changes you notice after treatment. Some people are quite bothered by the discovery of a ring no longer fitting or being unable to wear a watch. These changes are significant. It is important for your medical team to know not only what lymphedema-related physical symptoms you are experiencing but also how these symptoms affect your quality of life.
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Julie Berrett-Abebe and Corinne Holbrook are oncology social workers, Jean OToole is a physical therapy clinical specialist and certified lymphedema therapist, and Tara Russell is a lymphedema studies clinical research program manager, all with the Lymphedema Studies Program at Massachusetts General Hospital in Boston, MA. The authors each contribute to the care and support of breast cancer patients with and without lymphedema.
Help is available. For general information about lymphedema, visit the National Lymphedema Network’s website, lymphnet.org. To find a certified lymphedema therapist near you, search the Lymphology Association of North America’s online database at clt-lana.org/therapists.
This article was published in Coping® with Cancer magazine, September/October 2009.