• Mayo Clinic Minute: Lymphedema risk is not just about surgery

Many women diagnosed with breast cancer have surgery as part of their treatment. Removing lymph nodes along with breast tissue increases the risk of lymphedema, or swelling of the arm. Dr. Judy Boughey, a Mayo Clinic surgeon, says surgery is not the only cause of lymphedema.

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When breast cancer patients face surgery to remove the cancer and associated lymph nodes, many worry about the risk of lymphedema.

Dr.  Boughey says, “Lymph nodes in your armpit drain both the cancer cells from the breast, but they also drain your arm. And, so, when you’re removing those lymph nodes, it can decrease the lymphatic drainage from the arm. That lymph fluid then builds up in the arm, resulting in lymphedema.”

A study by Dr. Judy Boughey and colleagues shows surgery is not the only treatment that puts patients at risk of lymphedema. Radiation and chemotherapy may be culprits, too.

“It’s a multi-step insult that leads to this lymphedema risk. So it’s not just surgery alone. What this tells us is that lymphedema is an important aspect that patients need to discuss not only with their surgeons, but also with their radiation therapist and also with their medical oncologist.”

If a patient does develop lymphedema, addressing it early is key, because there are treatments that can help.

“We, nowadays, have many more opportunities to treat lymphedema than what we had 10 years ago and even 5 years ago. There are procedures that can be done to reconnect the lymphatics to different veins to get them to drain. We can do lymph node transfers, all kinds of procedures.”

“And, so, early recognition, early treatment, early intervention, I think, is critical to try to make this collateral damage as minimally impactful on the patient as possible.”