RESEARCH SIMPLY EXPLAINED

Who is affected and why?

(swelling that develops when the body’s lymphatic system cannot carry fluid away) can be present from birth or develop after damage to the (the body’s drainage system of fine vessels and lymph nodes that carries fluid away from tissue). After cancer treatment, the risk varies with the treatment and cancer type.

After breast cancer

A (a study that combines results from many other studies) of 72 studies found in 16,6 % of women on average. In (studies that follow patients forward in time from the start), the proportion was 21,4 %. The risk increased until about 2 years after surgery.1

When many (small parts of the immune system that filter lymph fluid) were removed, the proportion was 19,9 %, compared with 5,6 % when only the first node was removed.1

In a study of 936 women, 5 % had after (removal of only the first sentinel, or guard, lymph node in the armpit) and 16 % after (removal of many lymph nodes from the armpit) at follow-up after 5 years.4

After other cancers

A review of 47 studies involving 7 779 patients found in 15,5 % overall. The proportions differed between cancer types.6

(cancer of connective tissue or muscle), (cancer of the female reproductive organs), (a type of skin cancer) and (cancer of the urinary tract or male reproductive organs) can affect the . The chart shows the proportions in the review.6

Proportion with lymphoedema after different cancers 6

The proportion varied between cancer types in the review. 30 %, 20 %, 16 %, 10 % and head and neck cancer 4 %. Study methods and follow-up differed.6

Leg swelling after

In a study of 408 women, 37 % developed measurable within 2 years. In 60 % of those women it became lasting.7

In the GOG 244 study involving 914 women, the proportions were 34 % after endometrial cancer, 35 % after cervical cancer and 43 % after vulval cancer.8

What increases the risk?

The strongest evidence is for removal of many , radiotherapy, (medicines used to treat cancer) and excess weight. Infection or injury in the affected arm or leg may also increase the risk.1611

When is present from birth

In a study of 138 children and young people, the swelling was in the legs in 92 % of cases. Girls most often developed symptoms during their teenage years.9

Inherited causes are found in about one third of cases. This means many people do not receive a clear genetic explanation.10

Common misunderstandings

Studies have not shown a clear increase in risk from blood tests, blood pressure measurements or air travel on the treated side. This does not mean every situation is risk-free. Follow the advice from your healthcare provider.11

Strength training with gradually increasing resistance has been safe in the studies. Read more under Treatment by stage.1314

The information describes results in studies. Results vary between individuals. A doctor needs to assess your situation.

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