The Lymphatic System

Lymph is a waste product of all cells that returns to the circulation through a complex network of fine tubes that eventually drain into a major vein near the heart. The lymph ducts pass through the lymph nodes that are concentrated in the armpit, groin and neck, and act to remove any bacteria or abnormal cells.

Lymphoedema (lymphedema in the USA) is a common complication of surgery when lymph channels are disrupted by the removal of lymph nodes in the armpit or groin because of breast or other cancers. The lymphatic fluid is unable to return to the circulation normally and accumulates in the limb. The limb becomes very swollen, tense and sore.

In severe cases the arm is rock hard and three times its normal size. Ulceration and infection of the skin and deeper tissues in the affected limb may occur. The Stewart-Treves syndrome is another complication.

Lymphoedema is a very difficult problem to treat. Elevation, exercises, pressure bandages and a plastic sleeve that envelops the arm and is rhythmically inflated by a machine, can be tried. The severity varies dramatically from one patient to another, with only a partial relationship to the severity of the surgery. It often persists for many years before gradually subsiding as new lymph channels are formed.

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