ROCHESTER, Minn. — New research from Mayo Clinic finds that patients with lymphedema —swelling of the limbs caused by the accumulation of protein-rich fluids of the immune system — had twice the risk of developing skin cancer than patients without lymphedema.

Patients with lymphedema had a significantly higher frequency of developing basal cell carcinomas and squamous cell carcinomas on the lower extremities, according to the retrospective study published in Mayo Clinic Proceedings. The study contributes to growing information linking lymphedema to localized changes in immunity and a predisposition for cancer.

The study reviewed data from 4,437 patients who were diagnosed with lower extremity lymphedema at Mayo Clinic in Rochester from 2000 to 2020. Compared with a matched control group, the group with lymphedema had an increased risk of skin cancer, and for patients who had lymphedema in one leg, that extremity was nearly three times as likely to have skin cancer compared with the other leg.

Lymphedema can be caused by surgery or cancer treatments that remove or damage the lymph nodes, which carry fluids of the immune system. Less commonly, lymphedema can be caused by inherited conditions.

"Patients with lymphedema are not screened routinely by dermatologists, and inadequate screening may lead to delayed diagnosis and treatment," says Afsaneh Alavi, M.D., a Mayo Clinic dermatologist and the study's senior author. "Our findings suggest the need for a relatively high degree of suspicion of skin cancer at sites with lymphedema. There is a need for raising awareness in clinicians seeing patients with lymphedema, and these patients may need regular skin cancer screenings, since early detection of skin cancer is critical."

View this video of Dr. Alavi discussing the findings.

Skin cancer is the most common cancer worldwide, but few studies have looked at the prevalence of lower extremity skin cancer, according to the article. The study found that all common forms of skin cancer, including squamous cell carcinoma, basal cell carcinoma, melanoma and angiosarcoma, were more common in patients with lower extremity lymphedema.

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly, peer-reviewed journal that publishes original articles and reviews on clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. The journal, sponsored by Mayo Foundation for Medical Education and Research as part of its commitment to physician education, has been published for 97 years and has a circulation of 127,000.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Jay Furst, Mayo Clinic Research and Education Communications, newsbureau@mayo.edu

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