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The lymphatic system consists of many vessels that carry lymph (a clear, colorless fluid containing water and a few blood cells that originates in many organs and tissues) throughout the body. The lymphatic system helps to protect and maintain the fluid environment of the body by filtering and draining lymph away from each region of the body.
Often during a lumpectomy or mastectomy, some or all of the lymph nodes under the arm may be removed. The lymph nodes under the arm (also called the axillary lymph glands) drain the lymphatic vessels from the upper arms, the majority of the breast, the neck, and the underarm regions. The lymph nodes help to filter excess fluid, bacteria, and by-products of infections.
Whenever the normal drainage pattern in the lymph nodes is disturbed or damaged (often during surgery to remove the lymph nodes), swelling of the arm may occur. Radiation may also cause swelling of the arm. This swelling of the arm, caused by an abnormal collection of too much fluid, is called lymphedema.
When the lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema. Lymphedema may occur immediately following surgery, or months or years later. Not every woman who has a mastectomy will experience lymphedema.
There are several types of lymphedema. The acute, temporary, and mild type of lymphedema occurs within a few days after surgery and usually lasts a short period of time. The acute and more painful type of lymphedema can occur about 4 to 6 weeks following surgery. However, the most common type of lymphedema is slow and painless and may occur 18 to 24 months after surgery.
There are no specific diagnostic tests for lymphedema. The physician will complete a medical history and physical examination. The medical history may include questions regarding the following:
Treatment for lymphedema depends on the severity and extent of the condition. Prevention and controlling lymphedema play an important role with this condition since there is no cure.
Treatment may include the following:
Breast cancer patients who perform good skin care and exercise properly after mastectomy are less likely to develop lymphedema.