Who is at Risk for Lymphedema?

According to the World Health Organization (UN/WHO), each year approximately 250 million people acquire lymphedema, mainly as a result of mosquito-borne microfilaria parasite infection in the tropics. In industrialized nations, the onset of lymphedema is associated with complications following cancer treatment by means of surgery or radiation therapy. Women are particularly at risk of developing lymphedema in their arms following surgery or radiation therapy for breast cancer, or in their legs following treatment for cervical cancer, uterine cancer, etc. Men are particularly at risk of developing lymphedema in their legs following surgery for prostate cancer, testicular cancer, etc. Both men and women are at risk following treatment of malignant melanomas (skin cancer) with lymph node dissection and/or radiation involving an arm, hand, leg or foot.

About 50-70% of patients who have had axillary node surgery will develop lymphedema (1). Patients who have had axillary surgery plus radiation therapy are at even higher risk. It is estimated that at least 1-2 million breast cancer survivors are alive today after lymphadenectomy and that 400,000 of them cope daily with the disfigurement, discomfort and disability of arm and hand swelling (2). In six different recent reports from three different countries on the incidence of lymphedema in patients who had different breast cancer treatments, Petrek and Lerner noted that the incidence of lymphedema is about 20% (16-26%) (3). They also noted that the incidence remains the same or higher in patients having breast conservation surgery because of the postoperative radiation reaching the axilla. Axillary radiation to a dissected axilla was a strong predictor of lymphedema in all studies that evaluated this issue. The true numbers of patients suffering from any form of lymphedema is unknown. Based on the numbers above and other statistics, we estimate the incidence of lymphedema in the United States as follows:

Secondary Lymphedema: 2-3 million
Primary Lymphedema: 1-2 million