Swelling of the limbs with oedema of the interstitial space usually due to disruption of the lymphatic drainage. Usually distinguished from dependent oedema or causes of generalised oedema due to reduced oncotic pressure, although both these factors can contribute to or exacerbate lymphoedema.
Divided into age of onset:
- Milroy's syndrome (hereditary congenital lymphoedema)
- Lymphoedema praecox (onset usually around puberty)
- Lymphoedema tarda (Meige's disease, onset in adulthood)
- Extrinsic compression, e.g. tumour masses
- Iatrogenic, e.g. radiotherpay, groin or axillary dissections.
- Parasitic infections, e.g. filariasis (most common cause worldwide)
Lymphoedema after breast cancer
- More likely following axillary clearance, especially level 3.
- May be reduced by a more selective approach using sentinal node biopsy.
Venepuncture, cannulation, use of tourniquets and blood pressure cuffs should be avoided, where possible, in patients with previous axillary surgery there is assumed to be an increased susceptibility to infection due to poor lymphatic drainage. Increased pressure in the arm is may impair new channels formed with the subdermal or intradermal spaces.
- ↑ O'Mahony S, Solanki CK, Barber RW, Mortimer PS, Purushotham AD, Peters AM. Imaging of lymphatic vessels in breast cancer-related lymphedema: intradermal versus subcutaneous injection of 99mTc-immunoglobulin. AJR. American journal of roentgenology. 2006 May; 186(5):1349-55.(Link to article – subscription may be required.)
- ↑ Suami H, Pan WR, Taylor GI. Changes in the lymph structure of the upper limb after axillary dissection: radiographic and anatomical study in a human cadaver. Plastic and reconstructive surgery. 2007 Sep 15; 120(4):982-91.(Link to article – subscription may be required.)
- ↑ Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM : monthly journal of the Association of Physicians. 2005 May; 98(5):343-8.(Link to article – subscription may be required.)