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What is secondary lymphoedema?


Lymphoedema is the regional accumulation of excessive amounts of protein-rich fluid in body tissue causing swelling. It occurs when the demand for lymphatic drainage exceeds the capacity of lymphatic circulation. The condition usually affects the limb/s, although it can also affect the trunk, breast, head and neck or genital area. Secondary lymphoedema can be acquired following surgery, radiotherapy, trauma or other damage to the lymphatic system following treatment for cancer. Secondary lymphoedema can develop at any time after surgery or radiotherapy.

Conservative estimates suggest that at least 20% of survivors from breast, gynaecological and prostate cancer, or melanoma will experience secondary lymphoedema. More specifically, the incidence of lymphoedema associated with vulval cancer is estimated at 36–47%, breast cancer 20%, cervical cancer 24% and melanoma 9–29%. Lower incidence rates are often associated with minimally invasive procedures such as sentinel node biopsy.

Key risk factors include extent of surgery, lymph node dissection and radiation treatment. Other factors include trauma, infection, body mass index (BMI) and immobility.