Lymphedema Causes and Risk Factors

Primary and Secondary Lymphedema

Lymphedema is primarily caused by abnormalities or damage to the lymphatic system, resulting in the accumulation of interstitial fluid and fibroadipose tissue in affected body parts, as stated by the American College of Cardiology 1, 2

Surgical lymph node dissection, especially axillary lymph node dissection for breast cancer, is a cause of secondary lymphedema, according to the American Cancer Society 3, 4
Radiation therapy, particularly to the supraclavicular lymph nodes or axilla, increases the risk of secondary lymphedema, as reported by the American Cancer Society 3, 4, 5
The risk of secondary lymphedema is lower with sentinel lymph node biopsy compared to full axillary dissection, as noted by the American Cancer Society 3, 6

Obesity, with a BMI >30 kg/m², is a significant risk factor for lymphedema that can also complicate diagnosis, as stated by the American Cancer Society and other guidelines 3, 4, 7
The extent of lymph node dissection, with five or more lymph nodes removed, increases the risk of lymphedema, according to the American Cancer Society 3, 4
Combined treatment with surgery and radiation therapy increases the risk of lymphedema, as reported by the American Cancer Society 3, 5
Recurrent infections in the affected area increase the risk of lymphedema, as noted by the American Cancer Society 3, 5

Lymphedema presents with swelling that may be unilateral or bilateral, a positive Stemmer sign, and a lack of response to elevation or diuretics, as described by the American College of Cardiology 1, 2
Progressive worsening of lymphedema if untreated increases the risk of cellulitis, as reported by the American Cancer Society 3, 5
Failure to differentiate lymphedema from other causes of edema can lead to delayed diagnosis and progression of the condition, as stated by the American College of Cardiology 1, 2