During breast cancer treatment and afterwards, lymphoedema often proves to be more complex than expected: in addition to the arm, the thorax and breast may also be affected – areas which, in practice, have so far rarely been systematically assessed.

Breast cancer-related lymphoedema: the arm is frequently affected, whilst the breast and torso are often under-reported

Around one in five women undergoing treatment for breast cancer develops breast cancer-related lymphoedema – a debilitating side effect characterised by the accumulation of protein-rich interstitial fluid and/or regional swelling. 1 Whilst 88 to 93 per cent of cases affect the arm, 14 to 27 per cent involve lymphoedema in the breast and/or thorax1 – with significant implications for function and quality of life. However, experts estimate that the number of unreported cases of breast/trunk lymphoedema is higher, as there are as yet no clear diagnostic criteria.2,3 The earlier developing lymphoedema is detected, the more positively the course of the condition can be influenced.

Risk factors for the development of BCRL

Certain factors may increase the risk of developing breast cancer-related lymphoedema, for example4:

Factors associated with BCRL risk included
  • Axillary lymph node dissection
  • Taxanebased chemotherapy
  • Regional node irradiation
  • BMI>30
  • Rurality

Lower levels of physical activity and a higher number of metastatic lymph nodes have also been identified as risk factors.1 

Factors that are not associated with BCRL risk
  • Mastectomy
  • Age
  • Hypertension
  • Diabetes
  • Seroma
  • Smoking

Early education, prevention, detection and follow-up care regarding secondary lymphoedema in breast cancer

Patients should be informed of potential risks both before and after breast cancer treatment. Regular follow-up appointments help to detect changes at an early stage.5 Compression garments should be worn from the first day after surgery until three months after completion of adjuvant treatments (with the exception of hormone therapy). This treatment is relatively cost-effective and has been recommended as the treatment of choice by a panel of experts. Preventive compression garments may be particularly beneficial for patients at increased risk.5

Discover the right solution

Within the framework of complex physical decongestive therapy, medical compression therapy has proven to be an indispensable component in the treatment of lymphoedema: medical compression garments exert targeted pressure on the tissue. In doing so, they support lymphatic drainage and help to stabilise the tissue.

For the torso

For the arm

How women with BCRL can support their own well-being: regular exercices and self-management in everyday life

In addition to the therapeutic measures for breast cancer-related lymphoedema, the active involvement of patients also plays a crucial role. Among other things, it is particularly important to wear the prescribed compression garments consistently, to exercise regularly and to take good care of the skin.

Sources

1 Ren Y, Kebede MA, Ogunleye AA, Emerson MA, Evenson KR, Carey LA, Hayes SC, Troester MA. Burden of lymphedema in long-term breast cancer survivors by race and age. Cancer. 2022 Dec 1;128(23):4119-4128. 

2 Koehler LA, Mayrovitz HN. Tissue Dielectric Constant Measures in Women With and Without Clinical Trunk Lymphedema Following Breast Cancer Surgery: A 78-Week Longitudinal Study. Phys Ther. 2020 Aug 12;100(8):1384-1392.

3 Cornacchia C et al. BREAST EDEMA AFTER CONSERVATIVE SURGERY FOR EARLY-STAGE BREAST CANCER: A RETROSPECTIVE SINGLE-CENTER ASSESSMENT OF RISK FACTORs. Lymphology 55 (2022) 167-177

4Koelmeyer LA et al. Risk factors for breast cancer-related lymphedema in patients undergoing 3 years of prospective surveillance with intervention. Cancer. 2022;128(18):3408-3415.

5 Wong HCY et al. Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendations. EClinicalMedicine 2024;68:102441.