Breast Cancer-Related Lymphedema Program

A Leader in Prospective Screening

We screen for breast cancer-related lymphedema in all newly diagnosed breast cancer patients at the Massachusetts General Hospital Cancer Center. We treat the condition in its earliest stages. We have evaluated more than 6,000 breast cancer patients.

Our program's multidisciplinary team works together to:

• Ensure ongoing screening
• Educate patients about risk factors, signs and symptoms
• Provide top-notch management

If lymphedema is detected, we design an individualized treatment plan focusing on physical therapy.

What is Breast Cancer-Related Lymphedema (BCRL)?

Lymphedema is a lymphatic system disease that causes swelling. The lymphatic system collects extra fluid, known as lymph, as well as proteins and other substances, from the body's tissues. If the flow of lymph in the body is blocked, fluid can collect in the tissues under the skin. Patients who have undergone surgery or radiation therapy to the lymph nodes for breast cancer are at risk of developing Breast Cancer-Related Lymphedema (BCRL). Other risk factors include:

• Being overweight at time of breast cancer diagnosis (body mass index (≥25 kg/m2)
• Skin infections in the area of breast cancer treatment (cellulitis)

BCRL can develop weeks, months, or years after cancer treatment, however, most patients who develop BCRL do so within the first three to four years after cancer treatment. Possible early signs of BCLR include:

• Puffiness or swelling
• Clothing, bra or jewelry that feels tighter than usual or leaves a dent or mark on the skin
• A feeling of fullness in the affected area
• A feeling of heaviness or fatigue in the affected area
• An area of the skin that is red or warm to the touch

BCRL symptoms may look like those associated with other medical conditions. Call your treatment team if you have any of these symptoms.

Find additional educational information about breast cancer-related lymphedema.

Our Screening Process

Having a baseline measurement is greatly beneficial in screening for BCRL, which is why we encourage all our breast cancer patients to have a baseline arm volume taken prior to surgery and/or radiation therapy. We take this measurement using a device called a perometer. Perometers use photosensors and light-emitting diodes (LEDs) to illuminate and scan the limb.

Further measurements are then taken during and after your breast cancer treatment. The volume calculated at these appointments is compared to the initial baseline measurement, to detect subtle signs of swelling that may indicate BCRL development. The success of our screening program is demonstrated by the lower incidence of BCRL in our patients (<10.0%) compared to the national average (20.0%), and the success of more manageable and less burdensome treatment when BCRL is diagnosed in its earlier stages.

Treatment for Breast Cancer-Related Lymphedema (BCRL)

While there is no cure for BCRL, treatment can help minimize the burden you experience. In most cases, treatment focuses on physical therapy rather than medication. In working with a trained lymphedema therapist, you can learn to massage your arm, do helpful exercises and bandage your arm, if needed. Wearing a compression glove or sleeve during the day or at night may also be a treatment option.

Through early detection and the proper treatment plan, many lymphedema patients can maintain their daily lifestyle.

Research & Clinical Trials

Our research focuses on survivorship, investigation of symptoms, impact on quality of life and early detection and intervention of breast cancer related lymphedema, cardiac and pulmonary toxicity from radiation and partial breast irradiation in one-week radiation treatment for early breast cancer.

View our active clinical trials.

Since 2010, our team has published over 45 papers discussing Breast Cancer-Related Lymphedema.

View our publications list.