Redness over the Arm and Chest Area After a Breast Cancer Operation

 

Redness over the Arm and Chest Area After a Breast Cancer Operation

What is it? How to Prevent? What is the Treatment?

Reynaldo O. Joson, MD

April 7, 2013

If a patient develops redness over the arm and chest area after a breast cancer operation, the redness is usually due to “lymphangitis” or “cellulitis.”

“Lymphangitis” is an inflammation-infection of the lymphatic channels and is recognized by the appearance of red streaks on the skin (see pictures below).

“Cellulitis” is an inflammation-infection of the skin and subcutaneous tissue without pus yet and is recognized by the appearance of a diffuse or patchy areas of redness on the skin (see pictures below).

Both lymphangitis and cellulitis are usually triggered by a wound on the hand, forearm and arm on the side of operated breast.  The wound may be evident or non-evident.  Examples of evident wounds are a cut or a burn.  Examples of non-evident wounds are an insect bite or a pinprick.

Both lymphangitis and cellulitis can occur in patients who have undergone total mastectomy and partial mastectomy with a concomitant armpit procedure.

The incidence is uncommon but not rare.

The main preventive measure against the development of lymphangitis and cellulitis is a focused attention on the  avoidance of a wound  on the hand, forarm, and arm on the side of the operated breast.  If a wound has unavoidably occurred, it must be cleansed meticulously with soap and water and then observe for appearance of redness.

If lymphangitis and cellulitis occur, antibiotics are taken.  The antibiotics to be taken are those that are effective against Gram-positive microorganisms.   The outcome of treatment is usually very good with resolution of the lymphangitis and cellulitis usually within one week.

lymphangitis_gapas_13apr4D

Patient 1:

Note the burn near the wrist and redness below the elbow.

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lymphangitis_gapas_13apr4C

Patient 1:

Lymphangitis secondary to a burn.

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lymphangitis_gapas_13apr4B

Patient 1:

The redness – with red streaks – lymphangitis

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cellulitis_mrm_pretx_talens_11a

Patient 2:

Cellulitis, arm and chest area, 3 years after the operation.  No evident wound on the hand, forearm and arm.

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cellulitis_mrm_pretx_talens_11c

Patient 2:

Closer view of cellulitis, chest area.

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cellulitis_mrm_posttx_talens_1wkb

Patient 2:

Resolving cellulitis after one week of antibiotics.

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balajonda_13jan15_A

Patient 3:

Cellulitis, arm and chest area, more than one year after the operation.  No evident wound on the hand, forearm and arm.

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Patient 3:

Subsiding cellulitis, one week after antibiotic therapy.

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Advisory:

In patients with a breast cancer operation, beware of lymphangitis and cellulitis on the arm and chest area on the operated side.

The main preventive measure against the development of lymphangitis and cellulitis is a focused attention on the  avoidance of a wound  on the hand, forarm, and arm on the side of the operated breast. 

If a wound has unavoidably occurred, it must be cleansed meticulously with soap and water and then observe for appearance of redness.

If redness occurs, consult a breast specialist as soon as possible.

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