Lymphedema

Lymphedema Kathryn Peroutka, M.D. Andrews/Patel Hematology/Oncology

Lymphedema Lymphatic System Lymph fluid Lymph vessels lymph nodes Protein rich fluid, usually clear

Lymphedema Onset often insidious Can be provoked Often a nonpitting edema often involving the digits. Symptoms before Signs

Lymphedema Can occur in days to weeks 80% will occur within 3 years Can sometimes occur much later

Risk cont’d Reconstruction ? Immediate vs Delayed Positive Lymph Nodes ?

Other risk factors Obesity Age Heart disease/Hypertension

Impact of Lymphedema The way it looks The way it feels The way it functions The risk of infection - cellulitis

Issues Exercise Doesn’t increase risk Flying probably not a major problem

Risk More intervention = more risk Lumpectomy Mastectomy SLN (sentinel lymph node) 5% ALND (axillary lymph node dissection) 20% Radiation