Breast and trunk oedema after treatment for breast cancer

Lymphoedema Practitioner, Napier University/NHS Lothian School of Nursing, Midwifery and Social Care, Edinburgh Arm lymphoedema is a commonly recognised complication of breast cancer treatment (Franks et al, 2006). Given that the arm, breast and adjacent trunk quadrant share lymph drainage routes via the axilla, it is not surprising that oedema also occurs in the ipsilateral trunk quadrant and breast, with or without arm swelling, after breast cancer treatment (Figures 1 and 2). Breast and trunk oedema have a significant impact on quality of life and are associated with pain, reduced function, and tissue change and distor tion (Figure 3). They may, however, be ignored or minimised and assumed to be common sideeffects of breast cancer treatment that will resolve in time (Jeffs, 2006). Additionally, no fully validated method exists to measure oedema in these areas. Skilled assessment and management of breast and trunk oedema by specialist lymphoedema practitioners in par tnership with patients will alleviate and often resolve the problem. This paper will highlight relevant epidemiology, explore the impact of breast and trunk oedema on the patient and discuss assessment and management approaches. Breast and trunk oedema can occur with or without arm lymphoedema following breast cancer treatment and are often dismissed as common side-effects that will resolve. This paper discusses relevant epidemiology, explores the impact on patients and discusses assessment and management approaches including manual lymph drainage (MLD), compression therapy and Kinesio Taping methods. A number of issues are raised, including the lack of fully validated tools to identify and quantify breast and trunk oedema and the need for further research in this area of lymphoedema management. Anne Williams