In many circumstances, protein is an indicator of robust health. But it can also be an indicator of an underlying condition, like lymphedema.

“Lymphedema is a long-term condition that results in a buildup of protein rich fluid,” said Dr. Atilla Soran, director of the lymphedema program at UPMC Magee-Womens Hospital.

“(This) causes swelling in the arm, chest and breast after breast cancer treatment,” he said.

Lymphedema can be a side effect of breast cancer surgery or radiation treatment, which specifically target lymph nodes.

It's recognizable by several symptoms.

- Arm heaviness and swelling.

- Hardening skin.

- Reoccurring infections.

These are among the conditions that can stem from blockages in the lymphatic system.

Soran said lymphedema is considered a major posttreatment morbidity — a medical problem resulting from a treatment.

“Based on the type of breast cancer treatment, lymphedema can happen in up to 40% of patients,” Soran said.

For instance, a sentinel lymph node biopsy — which involves less than five nodes and no radiation — results in about a 1% to 3% risk of patients developing lymphedema.

But an axillary biopsy — which includes more nodes and radiation — can result in an increased risk of lymphedema by up to 40%.

“I think the most common misconception about lymphedema is that it's an expected consequence of breast cancer,” Soran said. “That it will come and go.”

Soran said without the proper treatment, lymphedema can be progressive.

The good news is lymphedema can be managed — even prevented, with proper education.

“Early diagnosis intervention is the key,” Soran said. “And lifetime remission is possible.”

UPMC Magee-Womens Hospital has a comprehensive lymphedema program, according to Soran, which has been in operation since 2004.

Here, patients can learn about prevention and treatments, participate in weight loss programs, learn new exercises and try compression wear, among other things.

The program has also been able to stay on top of lymphedemic research, according to Soran.

This includes indocyanine green lymphography (a way of using dye to map the lymphatic system) and magnetic resonance lymphangiography (a special type of imaging).

“I think the biggest advancement has been the development of diagnostic tools,” Soran said. “These techniques allow us to diagnose lymphedema before it turns to swelling.”

There are things Soran encourages patients who have recently been diagnosed and their families to keep in mind.

Maintaining a body mass index under 30, exercise and learning how to prevent infections all help to reduce the risk of developing lymphedema.

And while it's a chronic condition, Soran said it's imperative patients understand it can go into remission.

After all, Soran said a patient's willingness to work toward health is as much a part of the process as treatment itself.

“Daily patient commitment is the fundamental part of the treatment,” Soran said.

<b>Position</b>Director of the lymphedema program at UPMC Magee-Womens HospitalClinical professor of surgeryDirector of International Breast Fellowship Program and Clinical Research for Breast Diseases<b>Education & Training</b>Medical school — University of Ankara, TurkeyGeneral surgery residency — Department of Surgery NHS Ankara Numune Teaching & Research HospitalMPH — Graduate School of Public Health University of Pittsburgh