Lymphedema after breast and gynecological cancer - a frequent, chronic, disabling condition in cancer survivors.

The goal of our study was to determine clinical characteristics of women cancer survivors treated for secondary lymphedema, the time from cancer treatment to the development of lymphedema, and the effect of therapy on reduction of lymphedema and occurrence of erysipelas. We performed a retrospective study of women with secondary lymphedema after breast cancer (BR) and gynecological (cervical, uterine, ovarian, vulvar) cancers (GYN) treated at our Department from 2004 to 2010. The average time from cancer treatment to the development of lymphedema in our patients was 2.2 and 4.75 years in the BR and GYN groups, respectively, ranging from within days after the procedure to as long as 31 years. The duration of lymphedema in our patients before they first received appropriate therapy was on average 4.1 and 2.65 years in the BR and GYN groups, respectively. In our series, untreated lymphedema was a strong predisposing risk factor for erysipelas, whereas no cases of erysipelas were noticed after the establishment of therapy. Compression therapy was shown to be an effective measure to reduce lymphedema. The duration of required initial decongesting therapy with short-stretch elastic bandages was longer in patients with more long-standing edema. Lymphedema may first appear several years after the cancer procedure. Our findings emphasize the need for awareness of lymphedema as a possible long-term iatrogenic complication in cancer survivors to avoid a delay in diagnosis and therapy. Physicians in care of cancer survivors should actively look for lymphedema. Untreated lymphedema is a strong predisposing risk factor for erysipelas.