Massive Lymphedema Necessitating Disarticulation of Shoulder Joint Following Treatment for Carcinoma Breast

We report a case of massive upper-limb edema necessitating disarticulation, in a cancer survivor who tended to ignore instructions regarding preventive exercises since 2002 after completion of her treatment for breast cancer. However, she was in a family situation where she was constrained to physically involve in daily chores. Consequently, she presented 14 years later with a lymphedematous arm which weighed over 31 kg, necessitating disarticulation. We highlight the role of preventive exercises in postmastectomy patients and also the efficacy of continuous nerve block techniques in preventing the development of phantom limb pain in cases of disarticulation and amputation. The role of family support for a working female cancer survivor in a country like India needs to be addressed. We salute her commitment to her family as also her grit and determination. Shoulder disarticulation was the last choice for this woman. We also want to highlight the role of the community in monitoring and preventing such disasters.