Lymphedema After Breast Reconstruction: Are You at Risk?

By Cathy Kleinman-Barnett

I'm cancer-free. My breasts look great. How come my arm is so swollen?

Lymphedema is an accumulation of lymphatic fluid, or the clear interstitial fluid that is found between all the cells in the body. It can affect one arm or both arms after breast reconstruction, breast augmentation with implants, mastectomy or prophylactic mastectomy.

These surgeries can cause an obstruction in your lymphatic system and alter the flow of lymph fluid. Think of it as a clogged pipe: the excess fluid remains in your body and causes swelling. Other symptoms may include heaviness or tightness, pain, restricted range of motion, infection and thickening of the skin on your affected limb(s). As many as 70 percent of women who have breast cancer surgery will develop lymphedema.

While there is no cure, appropriate treatment can successfully manage lymphedema. This specialized treatment is called Complete Decongestive Therapy (CDT). CDT reduces the lymphedema, improves skin condition and function.

CDT consists of:

  • Range-of-motion exercises, stretching, and massage to stimulate lymphatic flow
  • Manual lymphatic drainage (MLD). This is a very specialized, non-invasive, gentle hands-on technique that helps to direct lymph flow out of the congested areas and into functional pathways.
  • Wearing a compression sleeve and glove during waking hours
  • Skin care
  • Patient education

CDT should be performed only by an occupational or physical therapist who has completed a minimum of 135 hours of specialized training and has successfully passed the rigorous testing.

About the Author of This Article
Cathy Kleinman-Barnett, OT, is a lymphedema/edema specialist in the Outpatient Rehabilitation Department of the Northwest Medical Center in Margate, FL. She received her master's degree in occupational therapy from Nova Southeastern University in Davie, FL. Kleinman has received her lymphedema specialty certification from the Academy of Lymphatic Studies and the Dr. Vodder School of North America. She received her bachelor's degree from Rider College in Lawrenceville, NJ.