FIG. 1.

(a) Marked lymphedema of the arm after breast cancer treatment, showing pitting several centimeters (white arrows) in depth (stage I–II edema). The arm swelling is dominated by the presence of fluid, that is, the accumulation of lymph. (b) Pronounced arm lymphedema after breast cancer treatment (stage II–III edema). There is no pitting despite hard pressure by the thumb for 1 minute (white arrows). The “edema” is completely dominated by adipose tissue. The term “edema” is improper at this stage, as the swelling is dominated by hypertrophied adipose tissue and not by lymph. At this stage, the aspirate contains either no lymph or a minimal amount. Color images available online at www.liebertpub.com/lrb