Thanks to modern treatment methods, the chances of recovery from breast cancer continue to improve. At the same time, long-term effects of treatment are becoming increasingly important: breast cancer-related lymphoedema is a common long-term consequence of breast cancer treatment. We provide support for the treatment of lymphatic congestion.

What is breast cancer-related lymphoedema?

The lymphatic system plays an important role in maintaining the body’s fluid balance and supporting the immune system. Breast cancer treatment can affect this sensitive system. Breast cancer-related lymphoedema (BCRL) is swelling that can occur in the arm, thorax and breast as a result of breast cancer treatment.

Chronic and progressive – breast cancer-related lymphoedema can be a long-term condition

Lymphoedema associated with breast cancer treatment is often more complex than expected: in addition to the arm, the torso and breast can also be affected – areas that, in clinical practice, have so far rarely been systematically assessed.

Lymphoedema can develop during treatment, but it may also occur years later. The prevalence of the condition increases significantly over time. More than 80% of those affected experience a chronic course, either persistent or recurrent.¹

Risk factors and causes: What does lymphoedema have to do with breast cancer?

The underlying cause is a disruption of the lymphatic system. This finely branched network transports substances dissolved in fluid, such as proteins, fatty acids and inflammatory products, away from the tissues. If lymphatic drainage is impaired, protein-rich fluid accumulates in the tissue. The following treatments can cause lymph fluid to build up in the tissue:

Surgical removal of lymph nodes

Lymph nodes in the armpit may need to be removed as part of breast cancer surgery, including during a mastectomy. Removing lymph nodes can reduce the capacity and transport function of the lymphatic system. The remaining lymphatic vessels are placed under greater strain, which can lead to lymphatic congestion over time. The more lymph nodes are affected and need to be removed, the greater the risk of developing lymphoedema. The arm on the side of the body affected by surgery is most commonly affected, but the armpit, breast and thorax or trunk can also be affected.

Radiotherapy and chemotherapy

Radiotherapy can also affect the lymphatic system. The treatment can cause scarring and tissue hardening. These changes can impede the drainage of lymph fluid and increase the risk of developing lymphoedema.

What are the signs and symptoms of breast cancer-related lymphoedema?

Breast cancer-related lymphoedema often develops gradually. The initial symptoms are usually non-specific and may therefore not be recognised immediately. Typical symptoms include:

  • Skin changes, such as redness, hardening or thickening of the tissue
  • A feeling of tightness or heaviness in the affected area
  • Swelling of the affected area
  • Tenderness or pain
  • A feeling of fatigue or weakness

Many people affected by breast cancer-related lymphoedema do not initially notice visible swelling, but instead report that the affected area feels “different”. Such early changes should be taken seriously and assessed by a healthcare professional.

When do the symptoms occur?

Some women develop the first symptoms shortly after surgery. However, lymphoedema does not always occur immediately after treatment. It can also develop months or even years later. The risk remains throughout life, which is why long-term vigilance is important.

The arm is most commonly affected by breast cancer-related lymphoedema

While 88 to 93% of cases affect the arm, 14 to 27% involve lymphoedema of the breast and/or thorax, with a significant impact on function and quality of life.¹

Experts estimate that the actual prevalence of breast and trunk lymphoedema may be higher, as there are currently no clearly established diagnostic criteria. The earlier lymphoedema is detected, the better the course of the condition can be positively influenced.

Can breast cancer-related lymphoedema be prevented?

Complete prevention is not always possible. However, there are measures that can help to reduce the risk or detect early signs of lymphoedema at an early stage.

  • Early education and follow-up care: Women undergoing breast cancer treatment should be informed about the potential risks both before and after treatment. Regular follow-up appointments can help to identify changes at an early stage.
  • Compression for prevention: For women at increased risk, early compression therapy may be beneficial.² Medical compression sleeves apply targeted pressure to the tissue. This supports lymphatic drainage and helps to stabilise the tissue. Whether preventive compression is advisable should be assessed on an individual basis by a healthcare professional. Ideally, compression sleeves should be used from the first day after surgery until three months after completion of adjuvant treatment.² 
  • Regular physical activity: Physical activity promotes muscle movement and supports the transport of lymph fluid. Joint-friendly forms of exercise that are performed regularly are particularly suitable.

Treatment of breast cancer-related lymphoedema

Although lymphoedema cannot be cured, it can be successfully managed in most cases. The aim of treatment is to reduce swelling, alleviate symptoms and maintain quality of life in the long term. Treatment is generally multimodal and combines several therapeutic approaches.

Complex Decongestive Therapy (CDT)

Complex Decongestive Therapy (CDT) is the standard treatment for lymphoedema and combines several complementary measures. These include manual lymphatic drainage, compression therapy, targeted exercise and consistent skincare. The aim is to reduce swelling, promote lymphatic drainage and prevent the lymphoedema from progressing.

Manual lymphatic drainage is a specialised physiotherapy technique. Gentle, rhythmic movements stimulate the transport of lymph fluid and support decongestion.

Compression is a key component of treatment. Medical compression garments help to maintain the results of therapy and prevent the recurrence of fluid accumulation. Depending on the area affected, different compression garments may be used, for example:

  • Medical compression sleeves with a hand piece
  • Compression gloves or combined arm-and-hand garments
  • Medical compression bras, such as Bratelle
  • Specialised compression garments for the torso, such as embraceME

Compression garments such as embraceME are considered the treatment of choice once early-stage lymphoedema has been identified – they are cost-effective, low-risk and readily available.

Targeted exercise activates the muscle pump and thereby supports lymphatic transport. At the same time, it helps to maintain mobility, strength and body awareness.

Healthy skin reduces the risk of inflammation and infection. Regular skincare is therefore one of the fundamental components of treatment.

Self-management in everyday life

In addition to therapeutic measures, active participation by the woman affected plays a crucial role. Particularly important measures include consistently wearing the prescribed compression garment, careful skincare and maintaining regular exercise routines. Many clinics, lymphology centres and therapists offer specialised education and training. These programmes provide information about the condition and support women affected in managing lymphoedema safely in their everyday lives.

medi products – a comprehensive treatment concept

Modern medical aids make an important contribution to the long-term management of lymphoedema. Individually tailored compression garments and solutions now combine therapeutic effectiveness with a high level of comfort and suitability for everyday use.

Breast / Torso

Arm

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 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 024;68:102441.