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Tamoxifen as primary treatment of breast cancer in elderly or frail patients: a practical management.

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Microsoft Word - 262.00.docx Lymphedema: What Every Woman With Breast Cancer Should Know Hand and Arm Care After Surgery or Radiation Therapy for Breast Cancer What is lymphedema? During surgery for breast cancer, the doctor might remove one or more lymph (limf) nodes from the underarm area to see if the cancer has spread. When lymph nodes are removed, lymph vessels that carry fluid from the arm to the rest of the body are also removed because they route through and are wrapped around the nodes. Removing lymph nodes and vessels changes the flow of lymph fluid in that side of the upper body. This makes it harder for fluid in the chest, breast, and arm to flow out of these areas. If the remaining lymph vessels cannot drain enough fluid from these areas, the excess fluid builds up and causes swelling, or lymphedema (limf-uh-dee-muh). Radiation treatment to the lymph nodes in the underarm can affect lymph fluid flow in the arm, chest, and breast area by causing scarring and damage, further increasing the risk of lymphedema. Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. It usually develops slowly over time. The swelling can range from mild to severe. It can start soon after surgery or radiation treatment. But it can also begin months or even many years later. Women who have many lymph nodes removed and women who have had radiation therapy for breast cancer have a higher risk of getting lymphedema. Doctors still do not fully understand why some patients are more likely to have problems with fluid build-up than others. It’s expected that in the future fewer women will develop lymphedema because: • Breast surgery and treatment keep getting more conservative (that is, more women are treated with breast-conserving surgery, which removes the cancer and a small amount of healthy tissue around it, rather than mastectomy, which removes the entire breast and more lymph nodes). • Research advances have led to methods

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