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Lymphedema

Lymphedema is caused by a backup of lymph fluid, which can lead to swelling in the arms, legs, breast, chest wall, trunk or groin.

Lymph circulates in your body through lymph vessels that are similar to blood vessels. It's filtered through lymph nodes — small structures that are clustered in your neck, underarm, groin and abdomen. When lymph is unable to drain freely through nodes or vessels, it backs up in soft tissues and causes swelling and pain.

Lymphedema: What you should know

  • There are two types of lymphedema:
    • Primary lymphedema, a rare inherited condition, results from an abnormally developed lymph system. It can cause symptoms at birth or later in life.
    • Secondary lymphedema, which is much more common, can happen when lymph flow is disrupted by surgery, a tumor, injury, chemotherapy, radiation or infection.
  • Secondary lymphedema is often a side effect of cancer treatment that includes surgical removal of lymph nodes or radiation therapy that involves the nodes. When lymph nodes are removed or vessels become blocked with scar tissue, lymph drainage can be affected and lymphedema can result.
  • Lymphedema can cause serious infections such as cellulitis, an infection of the skin and soft tissues, or lymphangitis, an infection of the lymph vessels. Without treatment, severe lymphedema can also cause lymphangiosarcoma, a rare form of soft tissue cancer.

How can I get help for lymphedema?

  • See your doctor early if you have any of the following symptoms in one or more of your limbs, chest wall, abdomen or groin:
    • Swelling (including fingers and toes)
    • A feeling of tightness, fullness or heaviness
    • Weakness
    • Itching, burning, pain, redness or thickening of the skin
  • If you're diagnosed with lymphedema, your doctor may refer you to an occupational therapist who specializes in the medical treatment of lymphedema, or to a surgeon who's an expert in treating lymphedema surgically.

Care for lymphedema at Rush

Your lymphedema care plan at Rush is tailored to your specific symptoms and needs, with the goals of decreasing pain and swelling, improving your ability to move freely and getting you back to the activities you enjoy.

Occupational therapy
Lymphedema-certified occupational therapists at Rush may use one or more of the following to relieve your symptoms:

  • Compression garments and/or wrapping the limb with bandages
  • A carefully controlled exercise plan that incorporates specific movements to help drain fluid
  • Skin care to prevent infection
  • Massage using special techniques to relieve lymphedema

Surgery
If you have lymphedema resulting from lymph node removal during cancer treatment, you may be a candidate for a vascularized lymph node transfer (VLNT) or lymphaticovenous bypass (LVB) performed by a highly trained Rush microsurgeon.

  • With a vascularized lymph node transfer, your surgeon will transplant healthy lymph nodes from elsewhere in the body to replace those that were removed.
  • During lymphaticovenous bypass, or lymphaticovenous anastomosis, microsurgical techniques are used to connect lymphatic channels directly to small nearby veins, bypassing non-functional parts of the lymphatic system.

If you experience lymphedema after mastectomy, it's possible to treat it and reconstruct your breast at the same time with a procedure called total breast autologous reconstruction (TBAR). TBAR builds a new breast using your own body tissue, including functional lymph nodes that your surgeon will reconnect so they drain lymph from their new location in your breast.

Why choose Rush for lymphedema care

  • Expertise you can trust. Rush is on the leading edge of lymphedema treatment. Our surgeons are highly trained in state-of-the-art microvascular techniques for transplanting lymph nodes and rewiring the lymphatic system.
  • Advanced diagnostics. We offer state-of-the-art diagnostic technology like ICG lymphangiograpy in the clinic setting, which uses a fluorescent dye to trace lymph drainage, pinpoint blockages and identify working lymphatic channels.
  • A holistic approach. Our occupational therapy team offers a complete, evidence-based program of massage, bandaging, exercises and skin care, all managed by certified lymphedema therapists — including therapists who specialize in managing lymphedema after breast cancer treatment.

Departments and programs that treat this condition