THEAmong the possible adverse effects, breast cancer also has secondary lymphedema, which causes an increase in the volume of a limb due to alteration of the lymphatic system. To raise awareness of this disease, Wednesday 6 Marchon the occasion of World Lymphedema Day, to the A. Gemelli University Hospital IRCCS the first edition of the Lymphedema Day SICPRE. The event has it aim to inform and raise awareness about this disease and is held in the Medicinema room on the 8th floor. The Chair of the event is the Professor Marzia Salgarelloreconstructive plastic surgeon at the Agostino Gemelli IRRCS University Polyclinic Foundation and President Beautiful After Breast Cancer (BABC) Italia Onlus.
Breast cancer and secondary lymphedema
We will talk in particular about secondary lymphedema to breast cancer, with the aim of informing patients about the risks and possible treatments, thanks to the presence of top experts in the field. Beyond doctors, physiotherapists and physiatrists, they will go on stage also patients who practice rowing and dragon boatingtwo disciplines to recommend in case of lymphedema, and patient associations: Beautiful After Breast Italia Onlus, Melavivo Association and the LILT. The event will be hosted by Annalisa Manducamedical-scientific journalist and presenter A7. There are two ways of participating: those who are in Rome will be able to attend the event, while those who are not in the capital will be able to participate onlineconnecting to the SICPRE Youtube page.
Lymphedema: what is it
Lymphedema is one pathology characterized by an increase in volume of the limbs, arms or legs, and more rarely the genitals. In most cases, lymphedema is secondary to lymph node removal operations, axillary or inguinal lymphadenectomy, but there are also congenital or infectious or post-traumatic forms. «According to data collected by OMAR, Rare Diseases Observatory, in Italy every year they register 40,000 new cases of lymphedema. Of these, at least half involve patients who have undergone the removal of lymph nodes following the onset of tumors. This removal then determines lymphatic stasis and therefore chronic swelling of the arms and legs. The incidence is growing. For this reason, SICPRE, the only plastic surgery company recognized by the Ministry of Health, has decided to also apply its proven format of traveling events for this pathology”, explains the Doctor Stefania de Fazio, President of SICPRE.
Lymphedema and breast cancer
“The upper limb lymphedema it is a not rare complication of mastectomy and axillary emptying operations for breast cancer. It is a chronic and worsening disease. This means that will accompany the patient throughout her life. The good news, however, is that today we can do a lot for lymphedemaboth thanks to physical therapies, which see physiatrists and physiotherapists on the front line with decongestive physiotherapy, bandaging and the use of a tailor-made compression garment that must be changed every 6 months, and thanks to plastic surgery. The goal is to drain the lymph towards the root of the limb», explains Professor Marzia Salgarello.
Lymphedema: what to do
«The first step in the treatment of lymphedema is control or reduction of body weight. Everything is fine therapythen, it must be customized to the individual patient. If necessary, we intervene with the highly specialized microscopic surgery, with incisions of about 2 centimeters, comparable to the cuts made to remove a mole. The impact on the patient is therefore minimal. In a healthy person the lymph is discharged into the venous blood after a long journey that passes through the lymphatic channels of the whole body and the lymph nodes up to the neck. After lymph node removal for oncological therapy, the lymph cannot be downloaded and therefore “clogs” the tissues of the affected limb. The surgical intervention therefore aims to recognize the small lymphatic vessels that are still functioning, e.g create a bypass to pour the lymph into the small vein. In patients with lymphedema, the return of lymph into the veins is anticipated thanks to these bypasses. Another surgical possibility is the transplantation of lymph nodes from one site to another. But this is a more elaborate surgery also for the patient to apply in selected cases”, continues Professor Salgarello.
A neglected pathology
«Lymphedema is one pathology that has long been neglected. Even today many women accept it without even reporting it to their doctor. Lymphedema is a sequela that can be treated with physical therapies such as lymphatic drainage and elastic compression or, in selected cases, with microsurgical techniques which allow us to avoid dramatic situations that unfortunately we still see. This is why as BABC Italia Onlus we have the very important role of talk to patients and raise their awareness about lymphedema in order to be able to treat and prevent», underlines the Professor Adriana CordovaFull Professor of Plastic Surgery at theUniversity of PalermoHead of the Plastic Surgery Unit University Hospital Policlinico Giaccone of Palermo and member of the board of BABC Italia Onlus.
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How to prevent
«By knowing the pathology in many cases there is the possibility of preventing it, focusing attention on the arm: following lymphadenectomy (and especially in cases of radiotherapy of the axilla) the arm must be treated with extreme delicacy, as if it were made of crystal. This means, for example, avoiding injections. In case of blood sampling for routine checks, access routes to the veins of other sites must be used. You should not subject your arm to trauma or lift weights. Instead, they should be encouraged specific exercises which, at least initially, they must be recommended by the physiotherapist. Additionally, physiatrist consultation is required to receive pharmacological and dietary indications. In short, the treatment of secondary lymphedema, a consequence of breast cancer, requires a multidisciplinary approach and the figures of the physiatrist and physiotherapist which, precisely for this reason, have now become a full part of the breast units”, concludes Professor Cordova.
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