Breast reconstruction after lymphedema
Dear OncoLink "Ask The Experts,"
I had a bi-lateral mastectomy July 2002, the left side was cancerous, right side done for prophylactic reasons. Lymph nodes were removed on the left side only. I recently developed lymphedema. I see a therapist 3 times a week for exercise and massage. I exercise and massage at home and have bandages, and will soon graduate to a compression sleeve. Treatment has been very successful, and the amount of lymphedema was small to begin with. I am planning on beginning reconstruction in August. My therapist is concerned about my lymphedema becoming worse due to the possibility of infection and interference with the lymph pathways we are now using. Do you have any information on this?
Andrea Cheville, MD, Director of the Abramson Cancer Center of the University of Pennsylvania's Cancer Rehabilitation Program, responds:
Your therapist is appropriately concerned regarding the risk of infection. However, since most surgeons place their patients on antibiotics following surgery this risk is minimal. The lymphatic channels draining the upper extremity are located above the area involved in surgical breast reconstruction. They will not be further compromised. Surgical manipulation of the chest can increase the risk of truncal (chest and abdomen) edema. Similar to arm edema, this can be managed with decongestive therapy.