Today will be my first post-surgery flight. I didn’t leave it too long  … it has only been a week since surgery. In the surgery, I had a sentinel lymph node dissection (SLND) on both sides (bilateral). If I were to listen to the rhetoric on the various breast cancer support group sites, I should be flying with compression sleeves on both arms – cause the removal of lymph nodes means I’m at increased risk for lymphedema. If you listen to the rhetoric, you might think that my arms will immediately swell upon entering the airplane. Fortunately, this is mostly just rhetoric. There are cases of lymphedema, but they are not as prevalent as the various patient communities would make you think.

I searched for credible information on lymphedema and flying and found this article: Lymphedema: Separating fact from fiction on the Cancer Network website (the article is free, you just need to sign up for a free account). I recommend that anyone who has had breast surgery involving lymph nodes take a read of this article – as specific quotes and scenarios can be drawn based upon your specific situation. In my case (I bolded a few key points):

• “Several retrospective studies have shown that the number of nodes removed and the risk of lymphedema do not correlate.”
• “Despite various lengths of follow-up, from 6 to 60 months, the prospective trials vetting SLNB as the standard of care for axillary staging demonstrate significantly reduced rates of lymphedema after SLNB (0 to 7%) compared with ALND (12% to 16%)”
• “Importantly, though, they also confirm that even with SLNB a small but clear risk of lymphedema remains.”
• “The fact that women having more than 10 nodes removed during SLNB did not develop lymphedema but women with the same number of nodes removed after ALND did reaffirms that the relationship between the nodes removed and lymphedema is complex. “
• “Although Boccardo et al documented that increased education and awareness can reduce the incidence of lymphedema,[30] it is also possible that increased education can influence patient anxiety.”
• “For example, more than 98% of women who have undergone ALND avoid blood pressures, intravenous catheter placement, and needle sticks in the ipsilateral arm, while more than 80% of SLNB patients do the same without documented benefit and theoretically less risk than those having ALND. Examination of the recommended risk-reducing behaviors reveals few objective data for or against each measure.”
• “The authors observed no difference in lymphedema rates between fliers and nonfliers (P = .42), but interestingly they found the practice of precautionary behaviors to be associated with an increased risk of lymphedema (OR, 6.2; 95% CI, 1.2–20.8; P < .04) among those flying.”

One of the challenges I face is that the precautionary advice regarding things to avoid in the affect arm (e.g. needles, blood pressure) can usually be done in the unaffected arm. For me, I don’t have an unaffected arm. So, I need to analyze the risk more deeply. Is it really a risk? or an unnecessary precaution? Good question!