Lymphoedema Management Following Breast Cancer Treatment

Specialist assessment and treatment for breast and arm lymphoedema in Newcastle upon Tyne.

Specialist physiotherapy to assess and manage lymphoedema affecting the arm, hand, breast or chest following breast cancer treatment.

Lymphoedema can develop following breast cancer surgery, lymph node treatment or radiotherapy. For some people, swelling develops soon after treatment, while for others it can appear months or even years later.

If you have noticed swelling, heaviness, tightness or changes in your arm, hand, breast or chest following breast cancer treatment, a specialist assessment can help you understand what is happening and how best to manage it.

At Embody Physiotherapy and Lymphatic Care, I provide personalised lymphoedema assessment and management in a calm, private home clinic in Newcastle.

If you have concerns about swelling or changes following breast cancer treatment, get in touch to arrange an assessment and find out how I can help you manage your symptoms.

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What is Lymphoedema?

Lymphoedema is swelling caused by a build-up of lymphatic fluid in the tissues.

Following breast cancer treatment, the lymphatic system can sometimes be affected by surgery to the lymph nodes or by radiotherapy, making it more difficult for lymph fluid to drain effectively.

Lymphoedema can affect the:

Arm or forearm
Hand and fingers
Breast
Chest wall
Underarm area
Trunk

It does not always cause obvious swelling. Some people initially notice a feeling of heaviness, tightness or fullness before visible swelling develops. Lymphoedema occurs in 7-20% of people who have had breast cancer surgery and treatment.

Lymphoedema can be a long-term condition, but early assessment, treatment and self-management can help control symptoms and reduce the impact it has on everyday life.

Signs and symptoms of lymphoedema

Following breast cancer treatment, you may notice:

Swelling in your arm, hand, breast or chest
A feeling of heaviness or fullness
Tightness in the skin or tissues
Aching or discomfort
Rings, watches or clothing feeling tighter
A change in the shape or size of your arm or hand
Changes in the texture or appearance of the skin
A feeling that one side of your body is different from the other

If you are concerned about changes following breast cancer treatment, you do not need to wait until swelling becomes significant before seeking an assessment.Changes in the texture or appearance of the skin

Lymphoedema following breast cancer treatment

Lymphoedema can occur after different types of breast cancer treatment, including lymph node surgery and radiotherapy.

Your risk can depend on the treatment you have received and how your lymphatic system has been affected. However, lymphoedema can develop at different times, so it is important to be aware of changes even if your breast cancer treatment was some time ago.

An assessment can help identify changes in your tissues and establish whether lymphoedema may be contributing to your symptoms.

Breast and chest lymphoedema

Lymphoedema does not only affect the arm.

Some people develop swelling or changes in the breast, chest wall or underarm following breast cancer surgery or radiotherapy. This can sometimes feel like fullness, tightness, heaviness or discomfort, and may occur alongside changes around a surgical scar.

Breast and chest lymphoedema can be particularly difficult to recognise because the swelling may not be obvious.

Specialist lymphatic assessment can help identify changes and provide appropriate treatment and self-management advice.

How can Physiotherapy help?

I offer specialist lymphoedema assessment and management following breast cancer treatment.

At your initial appointment I will take time to understand your breast cancer treatment history, symptoms and concerns before carrying out an assessment.

Where appropriate, I can take limb volume measurements to help identify and monitor changes in swelling over time.

Your treatment will be tailored to your symptoms, treatment history and individual needs and may include:

Manual Lymphatic Drainage (FG-MLD)

Manual Lymphatic Drainage (MLD) is a gentle, specialised form of hands-on treatment designed to encourage the movement of lymphatic fluid through the lymphatic system.

Treatment can be used for swelling affecting the arm, breast, chest and surrounding tissues where appropriate. I am trained in fluroscopy guided manual lymphatic drainage which is an evidence-based technique investigated and developed by Prof Jean-Paul Belgrado and uses a fill and flush technique.

Compression advice

Compression can form an important part of lymphoedema management. I can provide advice about whether compression may be appropriate for you and discuss the different options available.

Compression hosiery works by:

preventing re-accumulation of oedema
encourgaes the fluid to move to the root of the limb
provides a firm foundation for the muscles to work against to pump the lymphatic fluid
Provides graduated compression.

Multi-layer bandaging

Where appropriate, multi-layer bandaging can be used to help reduce swelling before moving towards longer-term management strategies such as compression garments.

If multi-layered bandaging is recommended you will need to undergo a course of daily bandaging to reduced to swelling to a much more manageable level. I use short stretch bandages with a variety of padding for the bandaging.

Skin care and self-management

Good skin care is an important part of managing lymphoedema. I can provide advice on protecting your skin, reducing the risk of infection and incorporating lymphoedema management into your everyday life.

Exercise is also a very important part of lymphoedema management. Your lymphatic system doesn't have it's own "pump" to move the lymph fluid to the lymph nodes for it to be removed. It relies on your muscles and heart to provide pressure around the lymphatic system to move the fluid. Exercises don't mean that you need to necessarily go to the gym, some simple movements can make a big difference to your management and I can guide you through the most appropriate ones for you and your individual circumstances.

You will also be given practical advice and strategies to help you manage your symptoms confidently between appointments.

The function of your arm and upper body and your scar can have an impact on your lymphoedema. I will assess both of these during your assessment and can help with treatment of these alongside any lymphoedema management. Have a look at the Scar therapy and Breast cancer rehabilitation pages of the website for more information.

Frequently asked questions

What happens at your first appointment?

Your first appointment will last up to 60 minutes and personalised to you.

We will discuss your breast cancer treatment, your current symptoms and any concerns you have. I will then assess the areas affected and, where appropriate, take measurements to establish a baseline.

I will explain my findings clearly and discuss the treatment options that may be appropriate for you.

Your management plan may include hands-on treatment, compression advice, exercise and movement advice, skin care and strategies for managing your lymphoedema independently.

Can lymphoedema be managed?

There is currently no cure for lymphoedema, but it can usually be managed effectively.

The aim of treatment is to help reduce and control swelling, improve comfort and movement, protect the skin and give you the knowledge and confidence to manage your lymphoedema in everyday life.

For some people, a small amount of swelling may be managed with self-care and monitoring, while others may benefit from more intensive treatment or compression.

Your treatment plan will be individual to you.

When should I seek an assessment?

If you have developed new or increasing swelling, heaviness, tightness or changes in your arm, hand, breast or chest following breast cancer treatment, it is worth seeking specialist advice.

An assessment can help determine whether lymphoedema may be contributing to your symptoms and whether treatment or monitoring would be appropriate.

If you experience sudden swelling, redness, heat, significant pain or feel generally unwell, you should seek appropriate medical advice promptly as these symptoms can have causes other than lymphoedema.

Can lymphoedema develop years after breast cancer treatment?

Yes. Lymphoedema can develop at different stages following breast cancer treatment, including months or years later. If you notice new swelling or changes, it is worth having this assessed.

Can lymphoedema affect the breast rather than the arm?

Yes. Lymphoedema can affect the breast, chest wall and underarm area as well as the arm and hand. Changes may include swelling, fullness, tightness or discomfort.

Can I exercise if I have lymphoedema?

In most cases, exercise and movement are an important part of managing lymphoedema. I can provide individual advice based on your symptoms, treatment history and current level of activity.

How many appointments will I need?

This varies from person to person. Some people may need only a small number of appointments for assessment, treatment and self-management advice, while others may benefit from ongoing support. This will be discussed with you following your assessment.

Will I need to wear a compression sleeve?

Compression can be an important part of lymphoedema management and may help to control swelling and reduce the risk of it returning following treatment such as Manual Lymphatic Drainage (MLD) or multi-layer bandaging.

Whether compression is appropriate for you will be discussed during your assessment and treatment. There are many different types and styles of compression garments available, and I can provide advice about the options so that you can choose the most suitable garment for your needs, lifestyle and preferences.

How is swelling measured?

Where appropriate, I can take limb volume measurements to assess and monitor changes in your arm.

This involves measuring the circumference of your arm at regular 4cm intervals from the wrist towards the upper arm. These measurements are used to calculate the volume of each arm and compare the affected arm with the unaffected arm.

This provides an objective way of monitoring changes in swelling over time and can help to assess how your lymphoedema is responding to treatment

Do I need a GP referral?

No, you do not need a GP referral to make an appointment. You can contact me directly to arrange an assessment if you are concerned about swelling or other changes following breast cancer treatment.

If you are unsure whether lymphoedema management is appropriate for you, I can discuss your symptoms and concerns with you when arranging your appointment.