HSE Lymphoedema Trials Cut Breast Cancer Complications, But Postcode Lottery Persists
- Around one-quarter of breast cancer survivors in Ireland go on to develop secondary lymphoedema, a progressive condition causing tissue swelling in limbs, but early detection services have reduced...
- The HSE established three proof-of-concept early detection services in 2019.
- Melanie Hudson, a breast cancer survivor from Co Roscommon, developed lymphoedema after surgery where 14 lymph nodes were removed.
Around one-quarter of breast cancer survivors in Ireland go on to develop secondary lymphoedema, a progressive condition causing tissue swelling in limbs, but early detection services have reduced this incidence to approximately 2% in trial hospitals. The Health Service Executive operates surveillance programmes at The Mater Hospital and St James’s Hospital in Dublin alongside University Hospital Limerick. These clinics monitor patients for early signs to begin prompt treatment.
Expanding Surveillance and Proof-of-Concept Clinics Nationwide
The HSE established three proof-of-concept early detection services in 2019. Three additional proof-of-concept Specialist Lymphoedema Clinics operate in counties Meath, Donegal, and Clare. Funding is currently sought to expand these surveillance programmes to all oncology centres nationwide. Intervention services have resulted in an 87% decrease in hospitalisations due to complications such as cellulitis, according to the HSE.
Postcode Disparities in Post-Cancer Care
Melanie Hudson, a breast cancer survivor from Co Roscommon, developed lymphoedema after surgery where 14 lymph nodes were removed. She was not informed of the heightened risk beforehand. I had never heard of it until I was told I had it, basically,
she said. Despite living minutes from a primary care centre in Athlone, Co Westmeath, her Roscommon postal address prevents her from accessing manual lymphatic drainage there.
🏹These women are using archery to recover from breast cancer.The group, known as the Pink Arrows meet once a week to practise together in Spain.Many of the women have lymphoedema following their breast cancer treatment – a condition that causes painful swelling in the arm… pic.twitter.com/3b8qYF4B88
There’s nobody in the Roscommon HSE area trained in the delivery of manual lymphatic drainage. I’ve often heard the term the postcode lottery … the red tape and the bureaucracy of it is a little bit annoying because it’s forcing me to drive further than I should have to.
Melanie Hudson
Ms Hudson travels to the East Galway and Midlands Cancer Support centre in Ballinasloe in Co Galway for care. Severe swelling previously led to A&E admissions. She noted that earlier diagnosis and intervention would have prevented costly hospital visits.
Budget Requests and App-Based Prevention Trials
The Irish Cancer Society requested €8 million in Budget 2027 to fund nationwide prevention, early detection, and chronic management. The organisation estimates that hospital admissions associated to lymphoedema cellulitis equates to about €13.6 million annually. A Survivorship Manager with the Irish Cancer Society noted significant regional variation in service availability.
Meanwhile, the Purple Paddlers, a team of breast cancer survivors that race dragon boats on the River Slaney in Co Wexford, helped test the new LymphActive app. Lorraine Smyth Thompson, a digital manager with the HSE and a team member, helped develop the free application. The app includes skin care, nutrition, and exercise information with a timer and symptom tracker.
Many patients get caught because they think you only need to do exercises for a few weeks after surgery or a few months. Unfortunately, it needs to be done indefinitely.
Lorraine Smyth Thompson
The app will soon feature a specific stream for patients who already have the condition. The HSE first established proof-of-concept detection clinics in 2019.