More about lymphoedema

What is lymphoedema?

Lymphoedema is an accumulation of fluid (lymph) in the connective tissue of the arm or leg that causes swelling. It is caused by the fluid not being drained through the lymph nodes.

This can happen when lymphatic vessels do not work adequately (and thus cannot transport the absorbed fluid sufficiently) or when the lymph nodes have been removed (and thus a blockage occurs).

There are two forms of lymphoedema:

• Primary lymphoedema
  Lymphoedema can be congenital. In this case, the lymph vessels or lymph nodes do not work properly due to genetic problems. This can occur at different ages, but is rather rare.
   
• Secondary lymphoedema
  Lymphoedema usually results from cancer treatment, radiation, trauma or infection.

The lymph nodes in a particular region must be removed if metastases are found in the nodes (for example, the axillary nodes in breast carcinoma).

In addition, radiation or infection can damage the lymphatic vessels and/or lymph nodes, causing them to malfunction.

Up to 34% of patients treated for breast cancer may develop lymphoedema in the arm. This often appears sometime (often years) after the initial treatment for breast cancer, and may result from axillary gland excision, sentinel lymph node dissection and/or radiation therapy to the armpit.

What is the impact of lymphoedema?

The discomfort caused by lymphoedema when using the thick limbs can be very debilitating. Infections (lymphangitis) can also occur, as the lymph nodes are absent or functioning less well and thus can no longer contribute to the body's resistance (immunity).