I have written three prior articles on lymphedema associated with axillary dissection and Sentinel Lymph Node biopsy.  A recent presentation at the American Society of Oncology (ASCO) Breast Cancer Symposium was very interesting and so now is a good time to revisit that topic.

Cells from cancers of the breast will break off from the cancer and migrate through the lymphatic channels to the regional lymph nodes. As a result, removal of the lymph nodes serves two functions. First, the nodes can be studied under the microscope. If there are no cancer cells in the lymph nodes, the risk of recurrence of the cancer is much lower than if there is metastatic cancer in the lymph nodes and less aggressive treatment is required to control the cancer. Patients with cancer in their lymph nodes will require additional treatment and their chance of recurrence of the cancer is higher. Second, if the cancer does involve the lymph nodes, removal of as much of the cancer as possible is important prior to further treatment with radiation or chemotherapy.

Lymphedema is associated with surgical removal of lymph nodes during the process of axillary dissection or with radiation to the regional lymph nodes.  Other factors associated with lymphedema include obesity, limb infections, trauma to the limb and age.  We have previously reported on the association of obesity (Obesity Survey Results) with lymphedema and numerous reports have established a relationship between infection, trauma and age.  

Dear Kelly,

My husband is now receiving massage therapy for lymphedema in both legs. This occurred after a knee replacement. He did have cellulitis and was given anti-biotics for it. It is now under control. He is doing the wrapping of both legs and it has helped a little in bringing down the swelling. Is there a compression sleeve for the legs like there is for the arm? He is overweight and seems like he is not doing the massage therapy correctly. I am so afraid that his legs will get worse. I hope in time he will get to doing it better. A pump was suggested but still has to do the wraps. This is sort of new to us and needless to say are both worried about it. I can help but am afraid I won't be wrapping correctly. Would like to hear from you. Thank you so much for your attention to my problems.

Jane