Big arms after breast cancer: causes, what to do?

Arm lymphedema is a possible side effect of curative breast cancer surgery. Painful and unsightly, it is very difficult for women to live with, but new light surgical techniques could avoid it.

Among the sequelae of breast cancer treatment, Arm lymphedema is a very debilitating side effect for women. Fortunately, this so-called “big arm” syndrome tends to disappear with the new lightened surgical techniques. “The cessation of dissections is revolutionizing the future of women in terms of arm lymphedema” rejoices Professor Mahasti Saghatchian, oncologist and specialist in the care of women with breast cancer.

What is the “big arm” syndrome after breast cancer?

the upper limb lymphedema Where big arm syndrome is a swelling caused by slowing or blocking the flow of lymph. The accumulation of this liquid makes the limb swell and makes it painful. It’s a side effect linked to dissection of the lymph nodes in the armpit, a technique traditionally used in the treatment of breast cancer but which “is increasingly rare these days. says our expert. This effect is increased when the surgery in the armpit is associated with radiotherapy.

Why does the arm swell after lymph node dissection?

When cleaning out the armpit, the ganglia are removed from the arm what blocks the lymphatic drainage network.The subcutaneous fluid (lymph, editor’s note) is no longer evacuated and accumulates with dead cells that are no longer eliminated either. This accumulation causes lymphedema of the arm, that is to say that the upper limb of the operated armpit grows in size” explains the oncologist.

What are the symptoms of arm lymphedema?

Lymphedema of the arm is manifested by a swollen and painful limb. The skin and tissues of the arm are put under stress because of the lump. They become more fragile and therefore more permeable to bacteria. The risk of infection is therefore multiplied. “The slightest scratch will allow bacteria to cross this thin and fragile skin and cause an infection. of the arm that becomes red and even more painful“underlines our interlocutor.

“There is a lack of structures for post-cancer psychological follow-up”

There is no no treatment to stop lymphedema of the arm after breast cancer. No surgery can replace the removed lymph nodes. “This is why we decided to prevent this side effect upstream by replacing dissection of all lymph nodes by excision of the sentinel lymph node which consists in remove only the nodes closest to the tumor (between 1 and 3)“notes the oncologist.

What to do in case of big arm syndrome?

To relieve the symptoms of lymphedema of the arm, we carry out lymphatic drainage and physiotherapy sessions to mobilize the arm. The patient will wear compression sleeves (sort of custom-made compression stockings) on the arm to reduce the size, develops Professor Mahasti Saghatchian, A recent study has shown that wearing a compression sleeve preventively and early after surgery requiring axillary dissection can significantly reduce the risk of lymphedema. “It is important that women are informed and can have a sleeve prescription even before surgerysupports our interlocutor. “ The resumption or start-up of a physical activity including arm mobilization is very effective but unfortunately too rarely indicated for women“regrets the oncologist. But in many women, these solutions are not enough to reduce the edema“. There are also post-cancer spa treatments offering programs adapted to arm lymphedema (La Roche-Posay, Aix-les-Bains, Argelès-Gazost, La Léchère-les-Bains, Luz-Saint-Sauveur, Barbotan, Luxeuil-les-Bains, Evaux-les-Bains ). Finally, regardless of the solution implemented, it is advisable tobe accompanied psychologically during and after such treatments. But “there is a lack of structures and health professionals are not always sufficiently trained for post-treatment psychological follow-up, once the cancer is cured” recognizes our interlocutor.

How effective is lymphatic drainage?

Lymphatic drainage helps to relieve arm lymphedema but does not cure it. “Women must do it regularly to try to reduce the oedema. It’s not a definitive treatment.” emphasizes our interlocutor.

Thank you to Professor Mahasti Saghatchian, oncologist and specialist in the care of women with breast cancer.

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