Background-
Lymphedema commonly occurs post breast cancer and is a potentially debilitating and often irreversible complication of cancer treatment. Risk of BCRL is related to axillary surgery, radiation therapy, obesity and presence of infections.
Lymphatic Involvement
The lymphatic systems serves as the primary route for tumor metastasis. The axillary lymph nodes drain 75% of the lymph from the breasts and so therefore may swell in cancer. The increasing size of the tumor leads to a rise in the interstitial fluid pressure, and interstitial fluid is produced. The lymphatic vessels are highly permeable; thus the flow rate is approximately 100–500x slower. Lymph nodes act as a reservoir for tumor cells to form metastatic tumors.
Surgery and radiation implications-
Surgery implications: All of the lymph fluid from one side of the upper body drain to the axillary lymph nodes. The more lymph nodes and vessels removed, the greater the cause of Lymph edema.
Lymphedema is of particular concern, as it occurs in 6–30% of patients.
With the advances in medical sciences, breast cancer is now being diagnosed and treated at an early stage. This may prevent metastasis of lymphnodes.
Now, when possible, surgeon favour sentinel lymph node biopsy (SLNB). This surgery removes just the first few lymph nodes, the “sentinel nodes”, that drain fluid away from the breast.
2. Radiation treatment-
Radiation directly to the underarm carries the most risk for radiation-related lymphedema.
Physical therapy-
More than one in five patients who undergo treatment for breast cancer will develop lymphedema.
Therapy generally consists of:
- patient education that begins early in the post-operative period
- lymphatic drainage
- compression therapy (consisting of compression bandages, compression sleeves, or other types of compression garments),
- skin care
- lymph-reducing exercises (LREs)
Research has shown that no activity level, occupation, or hobby is related to developing lymphedema. It is thus essential to continue with engaging in all types of prior daily activities.
Also read- https://vcurehealthcare.com/why-train-balance-exercises/