Mayo Clinic Talks Vascular Medicine Series: Lymphedema Challenges and Successes
Nov 25, 2025
In this engaging discussion, Dr. William J. Casey III, a plastic surgeon specializing in lymphedema, and Dr. Andrea L. Cheville, a physiatrist focused on non-surgical care, explore the often-misdiagnosed condition of lymphedema. They highlight its complications, like chronic inflammation and cellulitis risk, and the importance of early diagnosis. Listeners will learn about innovative treatments, including surgical techniques like lymphovenous bypass, and conservative therapies that improve patient quality of life through a multidisciplinary approach.
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Epidemiology And Rising Risk
- Lymphedema prevalence is poorly defined but estimated at 1–3 per 1,000 in population studies and 15–20% after breast cancer with nodal removal.
- Rising obesity likely increases lymphatic insufficiency and contributes to more limb swelling cases.
Distal Involvement Suggests Lymphatic Cause
- Distal involvement (dorsum of hand or foot) often indicates a strong lymphatic contribution to swelling.
- Proximal-only swelling can still represent lymphedema, so there is no absolute rule.
Insidious Progression And Triggers
- Lymphedema can be insidious and triggered by events like infection or overuse that increase lymph production.
- Progression to stage two reflects failure to return to baseline and development of fibrosis and adipose changes.