Manish Champaneria, MD, a plastic surgeon at Scripps MD Anderson Cancer Center and Scripps Clinic, discusses lymphedema, which is a common swelling side effect of breast cancer treatment that can strike the lower or upper extremeties. Dr. Champaneria explains treatments for this condition, including surgery.
Lymph nodes are small, bean-like structures that are found within the lymphatic system. The lymphatic system helps transport lymph fluid. Lymph fluid contains lymphocytes to help fight bacteria.
Lymphedema is the chronic accumulation of lymphatic fluid outside of the lymphatic channels. It causes swelling of the limbs and is often associated with surgery, breast cancer surgery and radiation, and any surgery where lymph nodes are removed.
There are several causes of lymphedema. Throughout the world the most common cause of lymphedema is filariasis or an infection from a mosquito. Within the United States, the most common cause is from surgery, either breast cancer surgery, melanoma surgery, or any surgery that requires lymph node removal with radiation.
The symptoms of lymphedema include chronic, debilitating swelling of either the lower extremities or the upper extremities. Sometimes they can cause pitting edema, which is pitting swelling in addition to infections. Sometimes your skin can change color as well as contour and shape.
Lymphedema can be treated through various means. The first means is to visit your lymphedema therapist who can help provide a compression sleeve. A compression sleeve helps compress the arm or the leg to help squeeze that fluid towards the center of the body. The other option is manual lymphatic drainage, which is a specialized massage of the arm or the leg to help push the fluid towards the center of the body.
The other surgical options include a lymph node transfer. A lymph node transfer is where we take lymphatics, or lymph nodes from one part of your body and transfer it to the area that is affected. The other surgical option is a lymphaticovenous anastomosis. That basically means connecting a lymphatic channel to a vein that is close by so that the lymphatic fluid can then be bypassed and infiltrated into the vein.