Most women diagnosed with breast cancer will need to undergo some type of surgery during treatment. The reasons for surgery can vary and may include removing the cancerous tumor from the breast (lumpectomy or mastectomy), evaluating whether the disease has spread to the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection), or reconstructing the chest to restore a more natural appearance. Any intervention (radiation therapy or surgery), which disrupts the drainage of the lymph nodes under the arm, can increase the risk of lymphedema.
What is lymphedema?
Lymphedema is an abnormal buildup of fluid (lymph fluid), which results in swelling, usually of the extremities (appendages). Lymph is the fluid that carries immune cells (mostly lymphocytes) all around the body. It is similar to "highway" for your immune system. Lymph nodes can be compared to "rest stops" for your immune cells. When the lymph nodes are removed, there is a backup of lymph into the surrounding tissues (because the "rest stops" are gone). This is called lymphedema. There is always a risk of developing lymphedema when lymph nodes are removed. This risk is the same whether lymph nodes are removed under the arm (as in breast cancer surgery) or any other part of the body (for example, people with melanoma). For more general information about lymphedema and other side effects of cancer and cancer treatment, see Managing Side Effects.
Types of lymphedema
Lymphedema can be primary or secondary. Primary lymphedema can be present at birth, develop at the onset of puberty, or occur in adulthood from unknown causes or from vascular abnormalities. Secondary lymphedema can be caused by any process that disrupts the drainage of the lymphatic channels. This can include infection, trauma, surgery, or radiation therapy. This article refers to secondary lymphedema due to surgery and/or radiation therapy for breast cancer.
Breast surgery and lymphedema
Lymphedema occurs in about 10% to 20% of women treated for breast cancer. The condition may develop when the axillary lymph nodes are removed during surgery and normal drainage of the lymph system is disrupted. If radiation therapy to the axilla is added, that can increase the risk of lymphedema substantially. Women who have had the following procedures may be at risk for developing lymphedema in the upper extremities:
A simple mastectomy in combination with axillary lymph node removal
A lumpectomy in combination with axillary lymph node removal
A modified radical mastectomy in combination with axillary lymph node removal
Radiation therapy to the underarm area after surgical removal of axilliary lymph nodes
The common thread in all of the above procedures is that the normal lymphatic drainage from the arm to the rest of the body is disrupted.
The development of lymphedema is often subtle and may first appear as a feeling of tightness around the shoulder, arm, or hand. A woman may also notice a decreased flexibility in the arm, wrist, or hand, or a heavy sensation in the arm. The condition may develop within a few days, months, or even years after surgery. In extreme cases, the lymphedema can extend from the hand through the entire arm to include the chest wall. Women should talk to the doctor if they suspect they may have lymphedema. While it's not possible to predict who will develop lymphedema, there are some steps women can take to reduce their risk.
A week after surgery and/or radiation therapy, begin daily stretching exercises as directed by your doctor or nurse. Continue these exercises up to 18 months after surgery and treatment to maintain your range of motion.
Maintain a healthy diet and reduce the intake of foods high in salt and fat.
Have two to four servings of fruits and three to five servings of vegetables every day.
Eat foods high in fiber such as whole-grain breads, cereals, pasta, rice, fresh fruits, and vegetables.
Drink eight, 8-ounce glasses of water daily.
Maintain an ideal body weight.
Avoid alcoholic beverages.
Exercise regularly. Be sure to check with the doctor before starting or resuming an exercise program. If your normal fitness regimen included using arm weights, ask the doctor how long you should wait before resuming the activity and whether there are any weight restrictions.
Lighten your purse and try not to carry it or heavy bags on the side where the surgery was performed.
Try not to carry young children in order to avoid arm strain.
A sudden increase in the amount of physical work performed with the arm on the surgery side can increase the risk of lymphedema (for example, packing up your house for a move)
More on exercising with lymphedema
To improve cardiovascular fitness, perform aerobic activities such as walking, swimming, or participating in low-impact aerobics for 20 to 30 minutes a day, three times a week.
Be sure to include a five-minute, warm-up routine such as stretching exercises before beginning a fitness program and a five-minute to 10-minute cool down period after an aerobic activity.
Stop exercising at the first sign of pain. If your arm on the side where you had the surgery becomes tired during exercise, cool down and elevate it.
Avoid infections
When more nodes are removed during breast cancer surgery, the risk of developing lymphedema and infections increases. This is because the lymph nodes help keep the immune system functioning properly by filtering harmful, foreign substances such as bacteria from the lymph fluid.
Below are steps women can take to avoid infections.
Wear gloves while doing housework or gardening.
Avoid having cuticles cut when getting a manicure.
Wash your hands with soap and warm water frequently, especially before preparing food and after using the bathroom or touching soiled linens or clothes.
Protect the skin from scratches, sores, burns (including sunburn), and other problems that might cause infection.
Use insect repellents to prevent bug bites.
Apply moisturizer daily to prevent skin chapping.
Avoid needle sticks of any type in the affected arm.
Use thimbles when sewing.
Use an electric shaver to remove underarm hair, as it may be less likely to cut or break the skin then other razors or hair removal methods.
Call the doctor at the first sign of infection. Be observant of the following symptoms in the arm or hand on the same side as the surgery:
Fever over 100º F
Sweats or chills
Rash or red blotches
Pain, tenderness, redness, or swelling
Wound or cut that won't heal
Red, warm, or draining sore
Managing lymphedema
There is no cure for lymphedema, which makes proper care and treatment of the affected arm even more important.
Ask the doctor to recommend an occupational therapist who specializes in managing lymphedema. The therapist will assess your condition and develop a treatment plan, which may include specific exercises, limitation of certain activities that are too vigorous or repetitive, and recommendations for complete decongestive therapy consisting of a compression sleeve, bandaging, manual lymph drainage, education in self-care and possibly a drainage pump.
Other ways to manage lymphedema
Avoid extreme temperature changes. For example, don't use hot tubs, whirlpools, saunas, or steam baths. Use warm instead of very hot water when bathing or washing dishes.
To prevent sunburn and skin breakdown, always wear sunscreen (at least sun protection factor, or SPF, 15) or cover the arm completely when outdoors, or stay out of the sun altogether, particularly during the hottest part of the day.
Avoid blood pressure readings in the affected arm.
When traveling by air, ask the doctor if you should wear a compression sleeve on the affected arm. If possible, keep the arm elevated (above the level of your heart) and flex it frequently during the trip.
When sitting or sleeping, elevate the arm on a pillow and avoid lying on the affected side for an extended period of time.
This article is the first in a series of three articles on options available to women after treatment for breast cancer. The other two articles will focus on breast prostheses and breast reconstruction. For an overview of these issues, read After a Mastectomy: What to Know.
2006-09-19 00:38:19
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answer #1
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answered by shakiff 2
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Drink lots of water, that's the first bit. Probably why Claritin bugs you so much actually. It dries you out quickly, and leaves you severely dehydrated. However, if you're looking for something that does work, without medications, then there are some excellent natural remedies available. Here's what I use, and there really are no measurements, be liberal: Onion soup Heaping amounts of garlic Additional onions Chili Powder Pepper And anything else that is spicy that you can think to put in it. When you go to eat it, you'll probably only want to do one cup at a time, but breathe in the fumes ( I mean, the steam) and drink it slow. It burns, you'll probably want a shower after words, and you'll definitely want to brush your teeth. But, it helps immensely with any sinus troubles you may be having. Clears 'em right out. I've used it for sinus infections myself, and it works extremely well.
2016-03-27 08:46:33
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answer #2
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answered by Anonymous
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Hi!
Before considering any medication be it natural or chemical, ask yourself these questions:
Did you get a new bra: You could be having an adverse reaction to the material.
Did you change your soap or your laundry detergent: You could be allergic to some soap or fabric softener.
Try rubbing a little olive or sesame seed oil (not roasted) or some vitamin E (break a capsule and smear on nipple). It could be a case of dry skin!
Did you notice other changes in your body?
I had a patient once coming to my office in panic. She had red blotches on her breasts, neck and shoulders. After careful questionning and requestionning, we came to the conclusion that it was the salsa!!! Her husband had taken a liking to salsa all of a sudden and eate it whenever they were watching tv! You guessed right, he had eaten the stuff prior to .... well you get the idea! Salsa has a bad habit of burning extra sensitive skin!
Before jumping to ''cancerous conclusions'' view all the possibilities. If in doubt consult!
2006-09-19 06:42:29
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answer #3
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answered by marie J 6
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