Lymphedema of the Breast: Find the Right Treatment for You

January 24, 2014 Providence St Mary Regional Cancer Center

In 2012, after a routine mammogram, Ruth Blair was diagnosed with breast cancer. She had a lumpectomy and radiation treatment.

“Right after radiation, I started having very thick, heavy feeling breasts,” Ruth said. “I was told this was a normal side effect of breast cancer treatment.” Her care team explained it would get better over time. But, instead, it started to get worse.

“I was so uncomfortable, I reached a point where I told my husband that I wished I’d had a mastectomy,” said Ruth. “I thought, Do I really have to live with this?”

Finally, on a follow-up visit, her nurse practitioner recognized that Ruth’s symptoms went beyond routine swelling and diagnosed Ruth with lymphedema of the breast.

What is Lymphedema of the Breast?

Lymphedema is an abnormal buildup of lymph fluid. It occurs when the flow of lymph fluid from one area of the body to another is blocked or otherwise interrupted, sometimes after lymph nodes are surgically removed or are damaged during radiation treatments.

The blockages affect the fatty tissues just under the skin and can cause swelling (edema) ranging from mild to intense. While lymphedema in the arm is a commonly recognized complication of breast cancer treatment, breast edema may be overlooked or confused with the general swelling that’s associated with surgery or radiation.

“I had no idea I was at risk,” said Ruth. “I received all sorts of education on what to look for, and be careful for, in my arm. In all the research I did, I didn’t find anything about lymphedema occurring in the breast.”

Symptoms of Lymphedema of the Breast

Along with a feeling of fullness and thickness, Ruth also displayed signs of peau d’orange, or a swollen pitted skin surface that resembles the skin of an orange. “It’s a very obvious symptom of breast lymphedema,” said Ruth.

  • Additional signs of lymphedema of the breast include:
  • Swollen breasts (with or without swelling in the arm or chest)
  • Breasts feel full or heavy
  • Skin that’s tight, hard, red or other changes in overall skin texture
  • Pain, tingling or other discomfort in the breast
  • Changes in breast size: one breast may be larger than the other
  • Your bra doesn’t fit the same

Unblocking the Log Jam

Treatment for lymphedema of the breast is designed to relieve buildup of lymph fluid.

“My physical therapist described it as undoing a log jam,” said Ruth. “You need to find the root of the jam and carefully work it loose.”

Techniques include gentle massage (mild lymph drainage), support bras and Kinesio Taping.

Kinesio Taping gained attention during the 2012 summer Olympics when beach volleyball players, runners – even table tennis players – used the colorful tape. Why? The tape’s slight tug on the skin is believed to stimulate circulation and help clear out damage in underlying muscles. And, when applied to areas surrounding the breast, the tape helps recreate the gentle massage like that performed during mild lymph drainage.

“I found Kinesio Taping worked the best for me,” said Ruth. Along with manual lymph drainage, her therapist trained Ruth to use the Kinesio Tape on herself. “Now, I just order the tape online and can apply it myself.”

Ruth started her lymphedema treatment in December 2013. And, after only two months, she considers it life changing. “I feel like a human being again.”

She encourages women to speak to their care team about the symptoms of breast edema – and to find a provider who specializes in lymph therapy to create a personalized treatment plan.

“I want women to know they don’t have to live with the discomfort.”

Other Treatments for Lymphedema of the Breast

Patients usually receive a combination of therapies to ease swelling and other symptoms. Each patient is different. So, a treatment that works for one patient isn’t necessarily the most effective for another.

Manual Lymph Drainage (MLD) – This form of gentle massage helps break up the buildup of lymph fluid and encourages proper flow.

Support Bras – Unsupported breasts may increase the problems associated with breast lymphedema. Women should be professionally fitted for a comfortable, well-fitted bra. Make sure straps are not cutting into your shoulders or back.

Compression Vests – Compression vests can help support breasts and help increase the flow of lymph fluid. Some women also find sleeping in compression vests helpful for nighttime comfort.

Chip Pads – Also called “Schneider packs,” these foam inserts may help knead or massage the swollen area. They can easily be added to compression vests or support bras.

Additional treatment options may include specific exercises to help reduce lymph fluid buildup, as well as topical skin care to help decrease irritation or inflamed areas of the breast.

How to Find a Lymphedema Therapist

There’s a variety of health care providers who specialize in lymphedema of the breast – from physical, occupational and massage therapists to nurses and physical medicine doctors. And, with training, many forms of treatment allow patients manage their self-care and take control of their healing process. I

f you think you might have lymphedema of the breast, talk to your care team. They can help you find a lymphedema therapist in your area.

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