Flying Doesn’t Seem to Increase Risk of Lymphedema

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Some doctors believe that the pressure changes the body goes through while flying on an airplane could trigger lymphedema in people who've had breast cancer surgery. A small study found that only about 5% of women who had had breast cancer surgery developed persistent arm lymphedema after flying on an airplane. The results were presented at the 2008 San Antonio Breast Cancer Symposium.

Arm lymphedema is the swelling of the arm or hand because lymph fluid has accumulated there. A network of lymph channels and lymph nodes in the body, along with the normal flexing and contraction of muscles, helps move the fluid out of the body's soft tissues and back into the bloodstream. Breast cancer surgery can disrupt the lymph channels and lymph nodes and change the way the chest wall muscle works. These changes can cause lymphedema to develop on the side where the cancer was removed. Numbness, discomfort, and infection (sometimes) can happen along with the swelling. Lymphedema isn't life threatening, but it can be annoying and can last for a while.

Lymphedema is more likely to happen when the underarm (axillary) lymph nodes are removed during mastectomy or lumpectomy. The risk of lymphedema is also higher when:

  • a large amount of tissue is removed during surgery
  • radiation therapy is given to the underarm lymph nodes
  • chemotherapy is part of the treatment plan

About 5% to 10% of women treated for breast cancer develop lymphedema during or after treatment.

The 75 women who participated in this study were all training for dragon boat racing. All of them had surgery to remove early-stage breast cancer. In the 2 weeks before a long distance flight, the women had a special test -- called whole arm bioimpedance -- that measured the level of soft tissue fluid in the arm on the side where the breast cancer was removed. The same test was done 3 hours after the women landed and again 2 months after the flight.

The results:

  • 15 of the 75 women had what was considered a significant increase in arm fluid right after the flight; most of these women (14 of them) had made the longest flights compared to the rest of the group. Most of these women (12 of them) had had more tissue removed during breast cancer surgery (mastectomy and complete underarm lymph node removal) compared to the rest of the group.
  • Only 8 of the 75 women had a large enough increase in arm fluid after the flight to be called true lymphedema.
  • Some of the women who had lymphedema right after the flight already had been diagnosed with lymphedema before the flight. Only 2 of the 75 women developed lymphedema for the first time after the flight.
  • Of the 8 women who had true lymphedema after the flight, 7 were tested 2 months later. The lymphedema had resolved in 4 of these 7 women.

Based on these results, the researchers concluded that flying on an airplane is unlike to cause or worsen lymphedema for most people who have had surgery to remove early-stage breast cancer. The researchers also pointed out that though some doctors tell people not to exercise and avoid heavy lifting to reduce the risk of lymphedema after breast cancer surgery, the women in this study were accomplished athletes (which involves exercise and lifting) and most were untroubled by lymphedema.

In the Breastcancer.org Lymphedema section you can learn more about minimizing your own risk of lymphedema after surgery.

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