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Beth Israsel Deaconess Hospital - Plymouth


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Lymphedema Information and Guidelines

What is Lymphedema?
Lymphedema is an accumulation of proteins and fluid in the tissues resulting in swelling in the arms or legs. Secondary lymphedema can occur following a surgical procedure involving removal of lymph nodes and/or as a complication of radiation therapy. Patients who undergo treatment for breast cancer may develop secondary lymphedema on the side of their surgery.

What are the symptoms?
Lymphedma after breast cancer treatment usually begins with swelling or a sense of “fullness” in the hand or arm. Clothing may not fit in specific areas, jewelry and watches may feel tight. It may occur immediately following surgery or several years later. Early diagnosis and treatment improves the prognosis and the condition. Untreated lymphedema can lead to a significant loss of arm function due to swelling, pain, and hardening of the tissue and the skin. It can also lead to infection and interfere with wound healing.

How is Lymphedma treated?
Lymphedema after breast cancer surgery can be successfully treated under the care of a Physical or Occupational Therapist specially trained in the methods of Comprehensive Decongestive Therapy. After a thorough evaluation, your therapist will design a program using the following:

1. Exercise with Compression Bandaging: Exercises are performed with the arm wrapped in a series of low-stretch bandages. The combination of the compression from the bandages and the pumping action of the muscle stimulates the reabsorption of fluid resulting in decreased swelling. Exercises to improve posture and increase shoulder mobility are also taught in order to reduce scar formation and enhance lymphatic fluid flow. This component alone can significantly reduce the edema.

2. Manual Lymphatic Drainage: This technique is a series of specific sequential strokes, focusing on superficial connective tissue rather than deeper muscle. The very light pressure of this massage facilitates the redirection and reabsorption of fluid and promotes the development of collateral channels for the lymph fluid to flow.

3. Proper Skin Care: Patients are instructed in proper skin care with focus on meticulous hygiene and prevention techniques to avoid infection.

4. Patient Education: Patients are instructed in self-manual lymphatic drainage, independent bandaging and a home exercise program to eventually manage the lymphedema independently. Patients are also instructed in proper posture and body mechanics to prevent injuries during activities of daily living.

How can I avoid developing Lymphedema?
By maintaining meticulous skin care and living a healthy lifestyle you may reduce the risk of developing lymphedema. The guidelines listed on the following page provide helpful hints that should be followed for a lifetime. If you have already been diagnosed with lymphedema these guidelines can help control it. If you have any concerns speak to your physician immediately.

Early diagnosis and treatment lead to the best prognosis.

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275 Sandwich Street
Plymouth, MA 02360
(508) 746-2000

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