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About Breast Cancer > About Lymphoedema

Lymphoedema Care


What is the lymphatic system?

The lymphatic system helps to protect our body from infection. There are lymph nodes all around the body including the armpits, groin, abdomen, chest and neck areas. Lymphatic vessels carry lymph fluid to the lymph nodes where harmful bacteria and viruses are filtered and destroyed.


What is lymphoedema?

Lymphoedema is a chronic inflammatory lymphastatic disease caused by mechanical failure of the lymphatic system. According to lymphoedema experts, it is an increase of lymph fluid content in spaces outside the cell membranes (1). This chronic symptom develops slowly and can appear months or even years after breast treatment.

Breast surgery or radiotherapy can cause damage to the lymph nodes and block the lymphatic flow. Studies show that the incidence of upper arm lymphoedema after breast surgery ranges from 5% to 56% within 2 years of surgery (2).


The early signs of lymphoedema

These are some of the early symptoms of lymphoedema. Since it is a chronic condition, they may come and go:

  • The affected upper limb may feel heavy, painful or ache.
  • Clothing or jewellery may feel tight because of swelling in a limb.
  • The upper limbs may look different, one may be bigger than the other.

Management of lymphoedema

At present, there is no cure for lymphoedema. Physiotherapy, such as exercise and manual lymphatic drainage, helps to lower the risk of secondary lymphoedema after removal of lymph nodes from the armpit (axillary dissection) in breast cancer patients(2). With proper daily care, symptoms of lymphoedema can be alleviated. However, if left untreated, swelling of the affected area will be aggravated, restricting limb mobility and eventually causing adverse impacts both physically and emotionally.


Lymphoedema Care Services (Service Price List)

Recognising the importance of prevention and detection of lymphoedema in its early stage; as well as proper lymphatic management, the Hong Kong Breast Cancer Foundation is introducing Lymphoedema Care Services.

We offer different treatment care to cater for the different needs and conditions of breast cancer patients and survivors, especially those who have undergone lumpectomy, mastectomy, sentinel lymph node biopsy or radiation.


Services for the Preventive Stage:

Services are offered to newly diagnosed patients and patients/survivors who are at high risk of developing lymphoedema.

Self Lymphatic Massage & Exercise Class

Conducted in a class setting, the class will teach the techniques for self-manual lymphatic drainage and provide preventive tips such as exercises, diet and lifestyle changes which could help alleviate the early symptoms.

Class schedule: once a month
Enrollment: prior registration required
Fee: free of charge

Measurement of the Lymphoedema Index

The measurement of the lymphoedema index provides information on the volume of intracellular and extracellular fluid in the affected limbs. It is carried out by passing small electrical currents through the limb and measuring the resistance of the current flows. The analysis can detect any disorder before it is clinically apparent. It is also helpful in monitoring the progress of the lymphatic treatment. This service is performed by our nurses and qualified lymphoedema therapist with the aid of Bioimpedance Spectroscopy (BIS) devices (L-Dex U400).

Service: appointment required
Fee:

HK$180 per measurement for HKBCF members

HK$280 per measurement for non-HKBCF members

Patient guidelines for measurement of the lymphoedema index

Prior to undergoing the measurement, one should:

  • hydrate normally
  • empty the bladder before measurement
  • refrain from exercise for 2 hours prior to measurement
  • avoid caffeine intake 2 hours prior to measurement
  • not consume alcohol for 12 hours prior to measurement
  • remove any compression garments before measurement
  • be certain you are not pregnant
  • be certain there is no pacemarker or other implanted electronic devices in your body

Services for the Treatment Stage:

This service is offered to those patients who have already developed lymphoedema.

Lymphoedema Management Groups

Lymphoedema Management Groups

In a small group setting, patients will learn how to perform self-manual lymphatic drainage and lifestyle modifications such as exercises and proper skin care in order to ease the discomfort.

Follow-up counseling will be provided for patients who are emotionally and psychologically disturbed by lymphoedema. Depending on the severity of individual cases, our nurses and qualified lymphoedema therapist will assess, recommend and make referrals where necessary to lymphoedema specialists for proper treatment.

Enrollment: prior registration required
Fee:

free of charge


How do I get Lymphoedema Care Services?

All breast cancer patients and survivors may access our Lymphoedema Care Services by medical referral or directly. If you are uncertain about which service best suits your condition, or about the preparation required prior to your lymphoedema index measurement, please discuss with our nurses and qualified lymphoedema therapist.


Enquiry/Registration

Telephone: (852) 2525 6033


References:
  1. Foldi, M. Foldi, E., & Stefan Kubik. (2006) Foldi’s Textbook of Lymphology. For Physicians and Lymphoedema Therapists. 2nd Edition.. Elsevier GmBH, Munich, Germany.
  2. Barclay, L. (2010). Early physiotherapy may help prevent lymphodema after breast cancer., BMJ, 340:b5396.

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