Lymphedema Post-Mastectomy CAT

Question 1

What causes lymphedema following a mastectomy?

Answer 1

Damage to lymph nodes and vessels during surgery

Question 2

What causes the accumulation of lymph?

Answer 2

• Excess load of lymph fluid
• Inability to transport lymph

Question 3

What are the long-term effects of lymph dysfunction?

Answer 3

• Chronic inflammation
• Further injury
• Fibrosis
• Hypoxia
• Increased risk of infection

Question 4

Clinical presentation for lymphedema

Answer 4

• Females > males
• Edema increases w/ dependent positioning
• Usually no pain, there’s a tight or heavy sensation

Question 5

Stage 1 Lymphedema

Answer 5

• Pitting edema that reduces w/ elevation overnight
• No fibrotic changes

Question 6

Stage 2 Lymphedema

Answer 6

• Some fibrotic changes
• Non-pitting edema w/ no reduction after elevation

Question 7

Stage 3 Lymphedema

Answer 7

• Skin changes
• Frequent infections
• Severe edema that is non-pitting and fibrotic

Question 8

Labs/imaging for lymphedema

Answer 8

• Doppler study to rule out DVT
• CT or MRI to rule out malignancy
• Lymphoscintigram

Question 9

Lymphoscintigram

Answer 9

nuclear medicine procedure to test function of lymphatic system

Question 10

PT management of lymphedema

Answer 10

• Complete decongestive therapy (CDT)
• Pt ed in skin care, hygiene, bandaging, self-massage, and exercise
• TI focuses on manual lymph drainage, short stretch compression bandages, retrograde massage, and exercise