POSTMASTECTOMY EDEMA OF THE ARM

EDEMA of the arm following radical mastectomy for carcinoma of the breast, in the absence of metastatic or recurrent disease in the axilla, has a reported incidence of from 10 to 50%. The edema varies in severity from a mild almost unnoticeable enlargement to massive swelling; disability may be so pronounced as to preclude use of the arm even to perform simple household tasks. There are many methods advocated for prevention and treatment of the condition, but the exact cause of the edema remains in doubt. HISTORICAL Halsted, 1 in 1921, published the first article dealing with elephantiasis chirurgica. It was his opinion that blockage of the lymphatic and venous channels predisposed toward edema but that it was necessary for infection to occur before the edema became significant. In particular, he believed that primary closure, with tenting of the skin across both axillary and infraclavicular spaces, which permitted pooling of