Care of Breast Cancer-Related Lymphoedema

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For most women, breast cancer and its treatment are often accompanied by lymphoedema. This phenomenon is described as a pathological accumulation of protein-rich fluid in the interstitial space which occurs due to impaired lymph transport and is accompanied by an increase in the affected organ volume. Timely assessment plays a vital role in successful treatment of lymphoedema. As many researchers have drawn attention to the problem, modern medicine has developed standards for diagnosing and treating this wide-spread disease.

The lymphoedemas clinical manifestations include swelling of the upper or lower extremities, violation of skin nutrition, the appearance of trophic changes on the skin, and subcutaneous fat tissue. Often, breast cancer surgery is complemented by lymph node dissection  excision of regional lymph nodes. In many cases, it cannot be avoided; however, the surgical tactics for this disease have become more conservative recently. The removal of the axillary lymph during the operation can subsequently violate the outflow of lymph from the arm. A direct consequence of this is swelling of the upper limbs on the affected side. The edema can appear not only in the area of the upper extremities but also on the chest and back. The assessment of lymphoedema is based on clinical data and methods of instrumental examination. The standard procedure for examining breast cancer-related lymphoedema is the circumferential measurement (Acebedo, 2015). The additional research methods can also include magnetic resonance imaging and ultrasound examination of blood vessels.

Unfortunately, lymphoedema cannot be cured entirely, but its symptoms can be controlled to avoid severe complications. Patient care in the case of breast cancer-related lymphoedema is a complex of physiotherapy methods that is called complete decongestive therapy. It involves daily manual lymph drainage or gentle massage of the ipsilateral arm to stimulate lymphatic fluid. It is performed by skilled specialists who also provide patients with the basics of conditioning and long-term self-care. Radical surgical intervention is now considered a last resort and is prescribed only in extremely severe cases.

Reference

Acebedo, J. C. (2015). Minimizing breast cancer-related lymphoedema. Practice Nursing, 26(2), 79-83.

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