Truncal Lymphedema

By Kellie Hayes, B.Sc, Certified Clinician

Last Updated: Mar 1, 2008
Articles & News : Articles : Lymphedema

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Truncal Lymphedema is the swelling of the chest wall, breast and back.  Some studies show that up to 80% of women may develop truncal lymphedema after certain breast cancer diagnosis and treatment procedures.  This swelling is caused by lymph fluid building up in the body tissue.  This swelling usually happens when the lymphatic system is damaged.  It may or may not involve the adjacent arm.

Lymphedema in the chest wall/breast can be difficult to diagnosis if the patient does not present with lymphedema of the arm.  As well, truncal lymphedema presents differently than in the arm.  Often intense pain, tenderness and a sense of fullness and hotness, not swelling (although this may be present), will be the first signs.  There may be a sense of fullness in the armpit, back, side, breast and along the scar tissue.  Although post operative swelling is normal, the identification of lymph is made by its persistence.  For patients who have undergone reconstruction the affected breast may be larger than it was before treatment.  Many patients will also report discomfort with movement and activities of daily living.  Visible indentations from bra straps or seams may be seen on the affected side, but not on the other side.  Other signs include a thickening of the skin or pitting (indentations) on the breast, chest wall or back.   

Who can be affected by truncal lymphedema? 

Women who have undergone a mastectomy, lumpectomy and women who have undergone reconstruction. 

The treatment of choice for truncal lymphedema is massage and the use of a compression bra to reduce the fluid build up.  It is important to choose the appropriate compression bra.  Many women mistakenly try to use mastectomy or sports bras, but these can actually block the drainage of fluid from the torso and make symptoms worse.  A good compression bra will provide compression in all areas of the torso where lymph can build, including the back and underarms.   

When should women wear a compression bra?

At the first hint of any symptom.

Symptoms of Truncal Lymphedema:

• Pain is a significant symptom and usually affects the shoulder and chest wall.  The pain that accompanies truncal lymphedema is usually more severe than pain associated with lymphedema of the arm.
• Chest wall swelling is most commonly located in the breast or on the chest wall, in the arm pit, above the collar bone and along scar lines.
• Swelling of the back usually appears as extra rolls of fat along the side of the back, fullness over the shoulder blades or upper back and sometimes fullness in the waist line.
• Swelling of the arm may or may not be present.
• Reconstruction complaints include the reconstructed breast is too large, misshapen and uncomfortable with movement.

Author, Kellie Hayes, B.Sc, Certified Clinician

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