What is the reason of arm swelling after breast cancer surgery? How to treat?

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Patient: a small mass of right breast in 2000. Early breast cancer.Radical surgery in 2000. Now the body can, that is, the arm has swollen.H

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Patient: a small mass of right breast in 2000. Early breast cancer.

Radical surgery in 2000. Now the body can, that is, the arm has swollen.

How to improve the treatment of arm swelling, the indicators are normal. Shanghai No.6 People's Hospital oncology Shen Chan: after radical mastectomy arm edema is common, about 20-30%, often caused by shoulder mobility, such as the lack of upper limb dysfunction after limb edema, numbness, pain and other sensory abnormalities, to the patient's daily life brings a lot of inconvenience.

This arm edema is a kind of lymphedema, is due to the normal structure of axillary surgery and / or radiotherapy after the lymph tissue destruction of the lymph return obstacles and accumulate in the subcutaneous tissue. In the early stage of edema, the site was soft and showed depression. Protein rich fluid skin in the process of fibrosis will appear a certain degree of brown, followed by hardening, hyperkeratosis and thickening. Severe cases of shoulder joint movement limitation, limb weakness and other upper limb dysfunction, numbness, pain and other sensory abnormalities, as well as limb deformities lead to psychological barriers.

Once the edema of the arm is called chronic, the treatment effect is not good, the following measures can reduce edema: 1, to avoid the upper limb blood flow is too high, to avoid high-intensity upper limb exercise, infection, etc.. 2, to avoid increased resistance to lymphatic reflux. For example, tight clothes may compress the supraclavicular region. 3, to avoid the side of the upper limb drug injection, blood, immune and blood pressure measurement. 4, avoid suffering upper limb high temperature, such as hot water immersion, sun exposure, sauna bath, etc.. 5, avoid wearing tight underwear, bra straps and necklace.

In addition, the prevention of infection and moderate exercise is also very important. Because of the lymphatic edema, the interstitial space is rich in protein, which can lead to bacterial infection. Therefore, attention should be paid to avoid insect bites, prevent skin damage, should be used immediately after the emergence of antibiotics. Moderate exercise and exercise help to improve lymphatic circulation. Such as stretching, abdominal breathing can change the internal thoracic pressure, promote lymphatic drainage. The upper limb lifting movement can make the muscle contraction stimulated lymph flow. However, excessive exercise or static activities (such as carrying heavy objects, etc.) can cause the lymphatic vessels to be overweight and aggravate upper limb edema.

Treatment can have the following two options:

The most important means of 1, professional and appropriate massage is the current treatment of lymphedema, through massage to empty the tissues surrounding the lymphatic vessels, lymphatic flow to accelerate the upper limb. Massage need an experienced teacher, with the hand skin movement in the subcutaneous tissue, the action should be moderate, rhythmic; if only in sliding surface of the skin is ineffective, and the excessive force may make the blood flow increase and aggravate edema. Massage is needed in a certain order, the first is bilateral neck, then the axillary and contralateral chest, then to the ipsilateral chest, ipsilateral shoulder, upper limbs and finally, often massage the upper arm, forearm and wrist and fingers, and finally.

2, pressure pump therapy: inflatable cuff in limb edema, intermittent inflated edema fluid centripetal flow. The air pressure device for multi cavity room, sequential and adjustable pressure gradient pump, pump pressure wave as well as centripetal decreasing, the edema fluid into the blood circulation. This method has a certain effect in the early stage of lymphedema and obvious subcutaneous fibrosis.

 

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