Name of the Condition

• Postmastectomy lymphedema syndrome
• Also referred to as post-surgical lymphedema or secondary lymphedema.

Summary

• Postmastectomy lymphedema syndrome is a condition characterized by swelling that primarily affects the arms and hands, commonly occurring after the surgical removal of breast tissue (mastectomy) and lymph nodes as a treatment for breast cancer.

Causes

• The condition is typically caused by the disruption of lymphatic drainage following the removal of lymph nodes during breast cancer surgery.

Risk Factors

• Risk factors include undergoing mastectomy or lymph node dissection, radiation therapy, obesity, older age, and complications following surgery.

Symptoms

• Symptoms may include swelling in the arm or hand, a feeling of heaviness or tightness, restricted range of motion, recurring infections, and skin changes.

Diagnosis

• Diagnosis is primarily based on physical examination, patient's medical history, and may be supported by imaging tests such as lymphoscintigraphy or MRI to assess lymphatic involvement.

Treatment Options

• Treatment includes physical therapy, compression garments, manual lymph drainage, exercise, and in some cases, surgery to improve drainage.
• These treatments aim to reduce swelling and prevent complications.

Prognosis and Follow-Up

• With proper management, symptoms can be improved, and the condition controlled, but it often remains a chronic issue requiring continuous follow-up.
• Regular monitoring helps prevent progression and manage symptoms effectively.

Complications

• Potential complications include chronic pain, frequent infections like cellulitis, and a decreased quality of life due to activity limitations.

Lifestyle & Prevention

• Maintaining a healthy weight, regular physical activity, avoiding trauma or injury to the affected limb, and practicing good skin care can help manage and potentially prevent worsening of lymphedema.
• Early intervention following surgery can also be preventive.

When to Seek Professional Help

• Seek professional assistance if there is a sudden increase in swelling, pain, signs of infection (redness, warmth), or if the condition significantly worsens.

Additional Resources

• For more information, visit resources such as the National Lymphedema Network, American Cancer Society, and Breastcancer.org.

Tips for Medical Coders

• Ensure accurate coding by verifying the patient’s history of mastectomy and presence of lymphedema.
• Avoid common errors such as confusing primary lymphedema with postmastectomy lymphedema, which is secondary and linked to surgery.