Breast cancer related lymphoedema (BCRL) Lymphoedema is a chronic, debilitating condition that is caused by the malfunctioning of the lymphatic system due to damaged lymphatic vessels and lymph nodes. Breast Cancer Related Lymphoedema (BCRL) is one of the most dreaded side effects post breast surgery and radiation therapy.
All diagnosed with breast cancer are at risk of developing BCRL in their life time. It might never or it may develop years post cancer treatment. It is important to be aware of the risk factors, symptoms and most importantly how to reduce the risk and manage early stage BCRL.
So how does the lymphoedema develop? The lymphatic system in our bodies is responsible for draining all the toxins from the tissue spaces, transport it to the lymph nodes where the toxic waste is removed from fluid known as lymph.
With surgery and radiation therapy lymph nodes may be removed and lymph vessels damaged resulting in a partial mal-functioning of the lymphatic system especially on the side of body affected by the treatment. It is also referred to as the blockage of the lymph vessels. This may result in swelling of the upper limb and alternative pathways are required to facilitate the drainage and flow of lymph from the affected areas.
So what are the symptoms of BCRL? The physical symptoms occur most commonly on the side where the cancer was treated and these may include:
Early stage symptoms
- Feeling of heaviness, numbness, pain of the upper limb
- Swelling of the limb and subsides after elevation
- Fingers swelling so ring not able to fit, or sleeve too tight or wrist swollen so watch strap not able to fit Moderate to Late stage symptoms
- Pitting of skin and swelling which does not subside after elevation – Hardening and or discolouration of skin
- Skin may tear or become infected (cellulitis)
The psycho–social symptoms may include:
- Anxiety and fear of cancer recurring
- Anti-social to avoid questions about the condition
- Low self- esteem and poor body image due to enlarged upper limb How to reduce the incidence risk?
- Be aware of the early stage symptoms
- Exercise is very important
- Taking good care of the skin to prevent damage through cuts and burns
- Don’t wear too tight clothing or jewelry
- Avoid very hot water, so wear gloves when washing dishes and bath and shower in warm but not very hot water
- Protect the skin by wearing long sleeve clothes or gloves when working in the garden
- Apply anti-bacterial cream immediately if cut or tear of the skin.
- If skin becomes very red and painful go to the community health center, or medical facility to receive antibiotics for the infection (cellulitis)
BCRL is a chronic condition that cannot be cured but it can be managed through a range of treatments and these include:
- Manual lymph drainage (gentle massage technique)
- Multi-layered compression bandaging or compression garment
- Skin care
Finally all breast cancer patients and survivors must become aware of the early symptoms and how to prevent or manage BCRL.
Compiled by: Colleen Marco Lymphoedema Therapist