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Lymphedema remains one of the most feared complications of breast cancer therapy, yet at the same time, is arguably one of the least well understood. Review of the literature reveals inconsistencies in defining and measuring this condition, as well as in understanding the extent of lymphedema that is clinically significant. The true incidence of lymphedema is widely debated, as are the risk factors leading to its development. The surgical removal of lymph nodes and disruption of lymphatic channels during dissection of the axilla clearly contribute, but there are other variables that play a role, including treatment-related variables such as use of radiation therapy, and patientrelated variables. Some of the most frequently reported patient-related factors are increasing age, higher body mass index, and weight gain. Although infection and injury have been reported to be inciting events in the development of lymphedema, these relationships are less clear. 1,2

Lymphatic Interrupted: Do We Really Understand the Risks and Consequences?