Causes of edema after breast cancer surgery

Upper limb lymphedema is one of the common complications after breast cancer surgery. It is mostly due to tissue destruction and/or tissue fibrosis caused by surgery, radiotherapy, trauma and other factors, resulting in local soft tissue adhesion and the reduction, compression and narrowing of small blood vessels and lymphatic vessels, thereby obstructing the reflux of blood and lymph, leading to increased interstitial protein concentration, reduced plasma colloidal osmotic pressure difference, increased amount of fluid leaving the capillaries, and ultimately edema.

Clinically, there are many specific causes that directly lead to or induce upper limb lymphedema. For breast cancer patients, the main reasons are as follows:

Radiation therapy

According to statistics, the incidence of upper limb edema can increase from 9% to 26% when radiotherapy is added after radical or modified radical surgery. This may be related to the large amount of radiation that causes occlusion and damage of blood vessels and lymphatic vessels in the radiation field. At the same time, radiotherapy can also cause local muscle fibrosis, compress veins and lymphatic vessels, affect lymphatic return in the upper limbs, and thus aggravate or cause upper limb lymphedema.

Infect

If breast cancer patients suffer from poor wound healing or improper wound care after surgery, leading to infection, the lymphatic vessels will be further damaged. At the same time, the reconstruction of lymphatic vessels and the establishment of collateral circulation will be hindered, thereby aggravating or causing upper limb lymphedema.

trauma

If the affected upper limb of a breast cancer patient is injured after surgery, it can also cause the local tissue to release chemical substances such as histamine and inflammatory factors, affecting vascular permeability, further affecting microcirculation, thereby aggravating or causing upper limb lymphedema. In addition, trauma may also lead to infection.

Fatigue, weight bearing

If breast cancer patients exercise or bear weight on the affected upper limb extensively after surgery, the blood circulation through the upper limb will increase, leading to a corresponding increase in lymph production, thereby aggravating or causing upper limb lymphedema.