breast lymphedema

mckenna

I had a lumpectomy for dcis but no lymph node removal. 3 weeks after surgery I had swelling and redness not near the incision site but on the same boob. The ro, mo, and original bs all have sen it. They had me on 3 different antibiotics none worked. I changed breast surgeons and she did not call it breast lymphedema but said it was swelling or edema from the 2 surgeries I have had. I started rads last week, the Edema is more painful.and worse now. I have tried some of the pain meds from surgery and they seem to be theonly thing that brings relief. My question is does anyone else have this and what do you do for the pain. Yesterday it felt better but I layed down for most of the day and that is not a good solution for the problem

kira66715

McKenna, it's a very common problem and there was a recent article published about how common breast edema and lymphedema is, and how often it's associated with redness, and can look like cellulitis.

If you head into radiation with it, it's likely you're going to swell more. The article suggested supportive and mildy compressive garments and lymphedema therapy. 

Let me see if I can't drag up the link to it:

http://www.ncbi.nlm.nih.gov/pubmed/22415476

Breast Cancer Res Treat. 2012 Mar 14. [Epub ahead of print]
A prospective study of breast lymphedema: frequency, symptoms, and quality of life.
Degnim AC, Miller J, Hoskin TL, Boughey JC, Loprinzi M, Thomsen K, Maloney S, Baddour LM, Cheville AL.
Source

Department of Surgery, Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN, 55905, USA, degnim.amy@mayo.edu.
Abstract

Although lymphedema of the arm is a well-known complication of breast and axillary surgery, breast lymphedema has received scant attention. We sought to prospectively characterize breast lymphedema's incidence, associated symptoms, clinical course, and impact on quality of life. Subjects were enrolled prospectively from a consecutive sample of patients undergoing non-mastectomy breast procedures (excisional biopsy or wide local excision ± lymph node removal) and followed for signs and symptoms of lymphedema in the operated breast. Symptoms and distress were serially assessed with 11-point linear analog scales. Breast lymphedema was diagnosed independent of symptoms, based on the distribution and degree of edema and erythema. One hundred twenty-four women were followed for a median of 11 months, and breast lymphedema was diagnosed in 38 (31%) women. Breast lymphedema was more frequent after breast surgery with axillary node removal (49%) compared to breast surgery alone (0%), p < 0.0001. Breast lymphedema involved multiple quadrants in most women and was characterized by edema in 100% and erythema in 79%. Patients with breast lymphedema were significantly more likely than women without breast lymphedema to report symptoms of breast heaviness (65% vs 22%, p < 0.0001), redness (62% vs 29%, p = 0.0006), and swelling (59% vs 22%, p < 0.0001), but symptom-associated distress was low overall. Three of 32 breast lymphedema patients with clinical follow-up developed chronic edema. Breast lymphedema occurs in approximately one-half of women who undergo breast surgery with axillary node removal. The condition is characterized by diffuse skin edema and erythema as well as self-reported symptoms with a low level of distress.

Now, in this article, they didn't see it with women with no nodes out, but I've worked in radiation oncology and saw it a lot after lumpectomies for DCIS.

Pain meds, gentle compression, some massage to get the fluid out of there--that would require referral to a lymphedema therapist:

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm

Let us know how you're doing.

Kira

mckenna

Thanks lira I did read this but since you posted it here I can easily pull this up at the ro tomorrow. I have had 6 of 25 fads and it is definatly getting worse.