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Lymphedema and Breast Cancer Surgery

If you have breast cancer, no matter which type of surgery you have, you will likely have one or more lymph nodes removed from under your arm. This is not the case if you have DCIS, since cells in DCIS will not travel to other parts of the body.

Lymph nodes are part of the immune system, which protects your body against infection and disease. Lymph nodes are small, round organs that are clustered in many areas of the body, such as the underarm. They are connected to one another by lymph vessels, which carry a clear fluid, called lymph. Cancer cells can spread to lymph nodes and other parts of the body through lymph vessels.

Once lymph nodes are removed, they will be checked for cancer. Knowing whether cancer is in the underarm lymph nodes can help the doctor decide if you need any treatment in addition to surgery. And, if so, what type you might need.

Lymphedema is swelling caused by a build-up of lymph. You may have this type of swelling in the hand, arm, chest, or back on the side of your body where lymph nodes were removed by breast cancer surgery or damaged by radiation therapy.

Some important facts to know about lymphedema are:

  • Lymphedema can show up soon after surgery.
  • Sometimes, lymphedema can last for years.
  • Lymphedema can show up months or years after cancer treatment is over.
  • Lymphedema might develop after an insect bite, minor injury, or burn on the arm where lymph nodes were removed or damaged.
  • Lymphedema can cause pain and other problems. To help with these problems, some people find it helpful to work with a physical therapist or doctor who specializes in rehabilitation and has special lymphedema training.

Sentinel Lymph Node Biopsy is a type of surgery in which the surgeon removes a few lymph nodes for testing. First, the surgeon injects a dye, a radioactive tracer, or both into the breast near the tumor. This helps the surgeon see which lymph nodes the lymph from that area of the breast flows to first. Then, he or she removes the node or nodes that contain the dye or radioactive tracer to see if they have cancer. If they do not contain cancer, it is not likely that the other nodes under the arm have cancer. This means that the surgeon usually doesn’t have to remove any other lymph nodes.

Fewer lymph nodes are removed with sentinel lymph node biopsy than with standard lymph node surgery. Having fewer lymph nodes removed helps lower the chances that you will develop lymphedema and other problems caused by damage to lymph vessels and lymph nodes.

Sentinel lymph node biopsy of the breast.

Credit: © Terese Winslow
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