Lymphoedema (treatment following breast cancer treatment)

• lymphoedema related to breast cancer can be due to lymphatic vessel compression, obstruction or more frequently due to breast cancer therapy (surgery or radiotherapy) (1)
• lymphoedema of the arm is a common, incurable complication of breast cancer treatment
• this complication seems especially likely if the treatment has included axillary surgical clearance or radiotherapy in addition to surgery to the breast itself
• some studies have revealed that the risk of developing lymphoedema is higher in women treated with both axillary dissection and adjuvant axillary radiotherapy compared to women treated with radiation to an undissected axilla (1)
• evidence relating to the effectiveness of treatments of lymphoedema following breast cancer treatment is limited - general measures include arm elevation, compression bandaging, exercise and massage - there is evidence that in patients with unilateral lymphedema of an upper arm or lower limb, that a course of multilayer bandaging followed by compression hosery led to a greater percentage reduction in excess limb volume than hosiery alone (2)
• it is important to maintain good skin hygiene
• antibiotics are used if infection is present

Reference:

• (1) Morrell R.M et al. Breast Cancer-Related Lymphedema. Mayo Clin Proc. 2005;80(11):1480-1484
• (2) Badger CM, Peacock JL, Mortimer PS (2000). A randomized, controlled, parallel-group clinical trial comparing multilayer bandaging followed by hosiery versus hosiery alone in the treatment of patients with lymphedema of the limb. Cancer, 88, 2832-7.
• (3) Drug and Therapeutics Bulletin (2000), 38 (6), 41-43.