Lymphedema is a common adverse effect and may negatively impact a patient’s body image.
Steven Chen, MD, MBA, discussed the physiological and physical impacts commonly associated with lymphedema after a breast cancer diagnosis.
Chen, breast surgeon and chief medical officer at Impedimed, discussed how lymphedema can lead to the constant reminder that patients have breast cancer because it’s so visible. Specifically, those who are undergoing mastectomy or reconstruction and dealing with those physical changes.
He also touched upon ways to identify lymphedema and tools to help with that. Even if clinicians or patients don’t have access to these higher-end tools, a measuring tape can be used to keep track of the lymphedema.
Transcript:
I think of lymphedema as having 2 different sets of impacts. One is the psychological [impact]. Once [patients] have lymphedema it’s a reminder that they had breast cancer and because some [patients] live with the most permanent visible, reminder that they had breast cancer, every time they look at their arm, and their clothes don’t fit right. Body image is a big issue for patients with breast cancer already and then [they] have a visible [characteristic] beyond what’s underneath their shirt. To have something visible is very distressing for patients psychologically and physically. We worry about skin changes; they may get dry skin and even some [patients] talk about having increased amounts of skin cancer. If you have chronic lymphedema, you can get a higher rate of infection.
I think the biggest take-home message that I would have is that we now have data that show that early intervention on subclinical pre-symptomatic lymphedema can stop the progression of lymphedema. Knowing this makes it much more important for clinicians to try to find those patients who have early lymphedema and not be so fatalistic about it. Part of catching it early is measuring it. I think the SOZO device is a great way to measure it. If you don’t have access to a SOZA device, which is becoming more common, at least use a tape measure. I would also say that the [National Comprehensive Cancer Network] guidelines, which are commonly used across a number of cancer centers, now specify in the survivorship guidelines that you should be measuring people who are at risk for lymphedema.
NCCN Clinical Practice Guidelines in Oncology. Breast cancer and survivorship, V.3.2020. Accessed March 21, 2024. https://shorturl.at/CFMSZ