(Primary Lymphedema; Secondary Lymphedema)
The lymph system helps your body fight illness. Lymph
fluid travels throughout the body in lymph nodes and
vessels. If these nodes or vessels are damaged or
missing the fluid builds up. Fluid build-up in the arms
or legs is called lymphedema. There are two types of
Primary lymphedema is uncommon and occurs
because people are born without lymph nodes and
Secondary lymphedema occurs when there is injury
to the lymph nodes or vessels.
Damaged Lymph Nodes
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While there is no cure for lymphedema, it can be
controlled. If you suspect you have this condition,
contact your doctor promptly for treatment.
Lymphedema can be caused by a variety of factors:
Born without lymph vessels and
Surgery for cancer
Radiation treatment for cancer
Surgery on blood vessels
Planned Lymph Removal for Cancer
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These factors increase your chance of developing
lymphedema. Tell your doctor if you have any of these
Surgery that removed lymph nodes
Breast cancer surgery (eg,
lumpectomy , mastectomy )
If you have any of these symptoms do not assume it is
due to lymphedema. These symptoms may be caused by other
conditions. Tell your doctor if you have any of these:
Swelling in arms, legs, fingers, or toes
Loss in range of motion
Aching, pain, or discomfort
Heaviness or tightness of skin
Your clothes, shoes, or jewelry feel tight
Hardening of the skin
Redness of skin
Cases of lymphedema can vary from mild to severe. Your
doctor will ask about your symptoms and medical history.
A physical exam will be done.
Tests may include the following:
Measurement of your arms and/or legs—to assess
the severity of fluid build-up
Lymphoscintigraphy—test that uses dye to trace
its travel through your lymph system
MRI scan —magnetic waves are used to make
pictures of body structures; used to look at
tissue affected by lymphedema
CT scan —type of x-ray that uses a computer to
make images; used to look at tissues affected by
Duplex ultrasound or Doppler ultrasound —test
that uses sound waves to make images; used to
look at blood flow and rule out blood clot
Talk with your doctor about the best plan for you.
Options include the following:
Your doctor or physical therapist may
show you exercises to drain fluid out of
your arm or leg. Massage may also be
used to help fluid draining. Sometimes
external pumps are used to help drain
the fluid build-up.
Compression stockings, sleeves, or
bandages are often used to direct fluid
away from your affected arm or leg. You
may be shown how to apply a compression
Compression stockings, sleeves, or bandages are
often used to direct fluid away from your
affected arm or leg. You may be shown how to
apply a compression device.
Areas of lymphedema are at risk for
infection. Your doctor may prescribe an
antibiotic to prevent or treat
infection. If the condition is painful
your doctor may suggest or prescribe a
Surgery to remove extra tissue from your
arm or leg may be considered in severe
If you are at risk for developing lymphedema, there are
measures you can take to help reduce your chance of
getting the condition:
Do not allow anyone to take blood or your blood
pressure on your affected arm or leg.
Wear a medical bracelet warning of your risk for
Keep your affected arm or leg clean.
Avoid crossing your legs or carrying items on
your shoulder if either area is at risk.
Keep hands and feet protected by wearing gloves
Maintain a healthy weight and eat properly.
Use an electric razor to shave.
Use sunscreen when outdoors.
Avoid ice packs or heating pads to the affected
If you had lymph nodes in your armpit removed
during breast cancer surgery, participating in a
physical therapy program may help to prevent
National Cancer Institute http://www.cancer.gov
National Lymphedema Network http://www.lymphnet.org/
Canadian Cancer Society http://www.cancer.ca/
Lymphedema Association of Quebechttp://www.infolympho.ca/
Lymphedema. Mayo Clinic website. Available at:
http://www.mayoclinic.com/health/lymphedema/DS00609 . Accessed November
Lymphedema. National Cancer Institute website. Available at:
. Accessed November 3, 2008.
Lymphedema. Society for Vascular Surgery website. Available at:
Accessed November 3, 2008.
What is lymphedema? The National Lymphedema Network website. Available
at: http://www.lymphnet.org/lymphedemaFAQs/overview.htm . Accessed
November 3, 2008.
1/22/2010 DynaMed's Systematic Literature Surveillance DynaMed's
Systematic Literature Surveillance : Torres Lacomba M, Yuste Sánchez MJ,
Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent
lymphoedema after surgery for breast cancer: randomized, single blinded,
clinical trial. BMJ. 2010;340:b5396.
Reviewer: Lawrence Frisch, MD, MPH
Update Date: 09/01/2011