[libribook.com] Traumatic Scar Tissue Management 1st Edition

Lymphedema
Breast cancer treatment often impacts upper body function. Dysfunction may be
due to fibrosis, lack of muscle strength, lack of flexibility, lymphatic
insufficiency (lymphedema) and neural hypersensitivity (Fourie 2008).
Lymphedema is caused by an inefficiency in the lymphatic system. Hydrophilic
protein becomes congested in the interstitial spaces of the extremities or trunk,
which causes swelling in the area.
Incidence statistics of lymphedema range from 5% to 60%, with the onset of
symptoms occurring immediately following surgery to up to 30 years postsurgery
(Poage 2008). Statistics for development of lymphedema for breast
cancer patients range from 2.4% to 56%. Once lymphedema is established it can
be managed but not cured (Fourie 2008).
Grade I Grade II Grade III Grade IV
Breast
appearance is
natural/normal,
feel is of normal
softness and the
capsule is
pliable/supple
Breast appearance is
natural/normal but
feels somewhat hard
to the touch and
pliability/suppleness
is somewhat
diminished
The breast feels hard,
pliability/suppleness is more
noticeably diminished and some
distortion is evident (e.g. presents as
an atypical rounded shape, or the
implant is generally tilted upwards)
Similar to grade III but
with greater distortion
and hardening of the
capsule –
pain/discomfort may
accompany this grade of
contracture