If you have had lymph node surgery such as an axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB) and/or radiation therapy as a part of your breast cancer treatment then you are at risk for breast cancer related lymphedema (BCRL). According to the National Cancer Institute, as many as 56% of women who undergo breast cancer surgery develop lymphedema within two years post-surgery, but the risk remains up to 30 years later [1]. Women who undergo ALND have a lifetime risk of up to 50% and women who undergo SLNB have a lifetime risk of 6% [2].
When traveling it’s important to be aware of travel-related risk factors that can exacerbate the condition and cause the onset of lymphedema or an increase in existing swelling. When traveling by air, the decreased pressure that is experienced within the cabin can give rise to increased swelling . The National Lymphedema Network recommends the use of compression garments to “provide external pressure on the extremity to adequately support favorable resorption and decrease the potential for fluid accumulation in the tissue”[3]. Wearing compression garments during air travel reduces lymphedema swelling risk by “First, resorption of fluid at the capillary level is enhanced due to the compression. Seconds, the garment or bandages stimulate the lymphatic system, via the muscle pump, and uptake of extracellular fluid increases, helping to prevent exacerbation of lymphedema” [3]. There are additional aspects of air travel that may exacerbate lymphedema risk or swelling. The sedentary nature of travel causes blood and lymphatic circulation to slow, standing, moving around the cabin and moving the affected limb frequently can help increase lymphatic fluid circulation and reduce swelling risk.
It is important to take into consideration that wearing compression garments in route can be just as important in avoiding swelling. When in route to the airport or if traveling by car or train it is best to avoid carrying or lifting heavy luggage and/or bags with shoulder straps with the affected or at-risk arm. Heavy bags can increase muscle stress, while bags with shoulder straps can create a tourniquet by impeding lymphatic circulation -- both of which can exacerbate swelling.
If you think you may be at-risk for lymphedema or have existing swelling, it is important to be properly fitted for a compression garment by your doctor, physical, occupational or lymphedema therapist prior to hitting the road.