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Truncal Lymphedema:
Risks, Symptoms, and Treatment

by Elizabeth Pennebaker, M.A., M.St., DPhil

Studies have estimated that breast cancer survivors have a 20%-80% chance of ending up with some form of lymphedema, whether it is truncal lymphedema (i.e. lymphedema of the chest, breast and back) or of the arm and/or hand.  It is difficult to predict who will get lymphedema and who won’t, but there are some variables that are known to increase the risk. Patients who have had more extensive surgery, more radiation, or greater scarring following diagnostic and treatment procedures are more likely to develop lymphedema than others.

It is crucial to keep in mind that truncal lymphedema can develop at any point – during treatment itself or thirty years later. For more information regarding risks and ways to avoid the onset of lymphedema see the NLN website: www.lymphnet.org.

Truncal lymphedema can present somewhat differently than lymphedema in the arms and legs, which may make it difficult for therapists or doctors to diagnose. Often pain and tenderness are the first signs, rather than visible swelling (although this may be a symptom too, of course). There may be a sense of fullness in the armpit, back, side and/or breast. Sometimes the affected breast may be larger than it was before breast cancer treatment. Visible indentations from bra straps or seams may be seen on the affected side, but not the other side. Other signs include a thickening of the skin or “pitting” (little pock-mark indentations) on the breast, chest, or back.

The treatment of choice for truncal lymphedema is massage (MLD), followed by the use of compression garments to reduce fluid build-up. It’s important, however, to choose an appropriate compression garment. Many women mistakenly try to use mastectomy or sports bras as compression bras, but these can actually block the drainage of fluid from the torso and make symptoms worse.  Moreover, even some compression bras are not appropriate for truncal lymphedema, because they do not provide coverage for all the areas of the torso that can be affected.

In upcoming issues of EW, we’ll explain the importance of compression bras in treating truncal lymphedema, and discuss the features a good compression garment should have. Until then, visit the Bellisse® website to learn more: http://www.bellisse.com/comfort_bra/features.shtml.