Home

Bellisse

Back to Articles

A Conversation with Lymphedema Therapist Lesli Bell, PT-LANA

by Elizabeth Pennebaker, M.A., M.St., D.Phil.

Q. How can you tell if a patient has breast lymphedema?
Lesli — Well, the symptoms are consistent with chronic edema and lymphedema, but the problem is that there is not yet an objective measurement for truncal lymphedema (that is, lymphedema of the breast, chest, and/or back). As a result, many less experienced practitioners often miss it. Therapists usually have to go by feel, because the visual signs are subtle, and often may be attributed to post-radiation effects. Also, because breast lymphedema is usually quite painful (in contrast to other edemas) it can often be misdiagnosed as an infection or, in extreme cases, inflammatory breast cancer. But if you don’t diagnose and control lymphedema, it can lead to exactly that – an infection. So detection and treatment are crucial.
Q. If you can't measure breast lymphedema,
how can you be sure you’re treating it appropriately?
Lesli — Using Manual Lymphatic Drainage and compression garments with arm edema is well documented in the literature. This approach improves the control of the problem dramatically. It makes sense that if you have an edema problem somewhere else, the same treatment would help. Anecdotally, we know that massage and compression frequently decrease patients’ discomfort in the chest and breast area. So how do we know how much massage and compression is therapeutic? We go by comfort. Believe me, our patients tell us very clearly that they are much more comfortable after treatment!
Q. What has been your patients’ response to treatment
with massage and compression garments?
Lesli — In my experience, once patients get treated with massage, they feel much better. However, it used to be that the only way to keep swelling down after treatment was with bandages – which were hard to put on, uncomfortable, and looked terrible under clothing. Now that a compression bra is available, my patients have a vastly improved quality of life. Some women I’ve seen couldn’t leave the house, couldn’t be touched, could hardly get through the day. After they were treated with massage and fitted with a compression bra, they stopped suffering and got their lives back again.