Breast Cancer: Lymphedema After Treatment
Lymphedema is swelling that may occur
after cancer surgery when lymph nodes are removed. It may also happen after radiation
the lymph nodes. It can start months or years after treatment. It’s a long-term (chronic)
condition that has no cure. But you can take steps to help keep it from starting.
does start, there are things you can do to reduce or ease symptoms.
If left untreated, lymphedema can get
worse. It’s important to know what lymphedema is and what you should watch for. Lymphedema
is easier to treat and treatment is more likely going to work if it’s treated right
What is the lymphatic system?
The lymphatic system helps the body
fight infection. It’s a network of tiny vessels and small, bean-shaped organs called
lymph nodes. The vessels carry lymph throughout the body. Lymph is a clear, colorless
fluid that contains a few blood cells. The nodes filter lymph to help fight
The lymph system helps protect and
maintain the fluid balance of your body. It filters and drains lymph and waste
products away from every part of the body. The lymph is carried back to bigger vessels
near your heart.
How lymphedema happens in breast
The lymph nodes under the arm are
called the axillary lymph nodes. They drain the
lymphatic vessels from the upper arms, most of the breast, and from the chest, neck,
arm pit. During surgery for breast cancer, these nearby lymph nodes (and vessels)
often removed. This disrupts the flow of lymph. The axillary lymph nodes also might
treated with radiation therapy. This can cause damage and scarring that also affects
way lymph flows through that area. All of this can lead to fluid buildup and swelling
the affected side. This is lymphedema.
When many lymph nodes under the arm
have been affected, you are at higher risk for lymphedema for the rest of your life.
Swelling can get worse and become severe. Skin sores, infection, pain, and other
problems can develop.
Lymphedema may start right
after surgery or radiation, or months or even years later.
A mild type of lymphedema
happens within a few days after surgery. This is normal. It usually lasts a
Lymphedema can also happen
about 4 to 6 weeks after surgery or radiation and then go away over time.
The most common type of
lymphedema is painless. It tends to slowly develop, most often within 3 years
of surgery. It does not get better without treatment.
Can lymphedema be prevented?
Lymphedema can happen any time
after surgery or radiation to the lymph nodes. The risk continues for the rest of
person’s life. Lymphedema can’t be cured, but it can be managed. Any swelling should
checked by a healthcare provider right away.
Doctors don’t know who will or
won’t get lymphedema. But there are things that can be done to help prevent it.
Women treated for breast cancer who
take good care of their skin and exercise after treatment may be less likely to develop
lymphedema. Staying at or getting to a healthy weight may also help lower your risk.
Newer types of lymph node surgery
have also helped lower lymphedema risk. But there’s no sure way to prevent
Preventing infection and injury
Protecting the arm on the side of
the surgery is very important after breast surgery. Poor drainage of the lymphatic
system can put that arm at risk for infection. Poor drainage can also make the arm
sensitive to extreme temperature. Be aware of activities that put too much stress
To protect your arm from injury and
infection, make sure to:
Ask for injections and blood
draws to be done on the unaffected arm if possible.
Ask for blood pressure
tests to be done on the unaffected arm if possible.
Not wear nightgowns or
clothing with elastic cuffs or tight bands.
Carry your handbag or heavy
packages with the unaffected arm or both arms.
Be very careful and use a
clean razor when shaving underarms.
Prevent sunburns and other
burns to the affected arm.
Wear gloves when gardening
and when using strong household cleaners.
Clean the skin of the
affected arm daily, gently dry well, and apply lotion.
Do approved exercises
regularly to improve drainage.
Eat a healthy, low-sodium
Not put extreme hot or cold
temperatures on the affected arm. This includes hot tubs, saunas, and heating pads
or ice packs.
Take good care of your
fingernails. Don’t cut or bite your cuticles.
Clean all cuts with soap and
water. Put antibacterial ointment and a sterile dressing on the cut.
Protect your fingers from
needle pricks and sharp objects. Use a thimble when sewing.
Not do vigorous, repetitive
movements against resistance with the affected arm. This includes scrubbing,
pulling, or pushing.
Tell your doctor right away
if you have any signs of infection. These include redness, pain, heat, increased
swelling, or fever.
Symptoms of lymphedema
The main symptom of
lymphedema after breast cancer treatment is swelling of the arm on the side where
nodes were removed. The amount of swelling may vary. Some people may have severe
swelling (edema). The affected arm can be several inches larger than the other arm.
Others will have a milder form of edema where the affected arm is only slightly larger
than the other arm.
Other symptoms of lymphedema may
Feeling of fullness,
heaviness, or tightness in the arm, chest, or armpit area
Bra, clothing, or jewelry
don’t fit as normal
Aching or new pain in the
Trouble bending or moving a
joint, such as the fingers, wrist, elbow, or shoulder
Swelling in the hand
Thickening of or changes in
Weakness in the arm
If you notice any of these
symptoms, see your healthcare provider right away. Treatment needs to be started right
away to keep lymphedema from getting worse.
How is lymphedema diagnosed?
There are no tests for lymphedema.
Instead, your healthcare provider will ask about your health history and do a physical
exam. You’ll be asked about:
Past surgeries you’ve had
Any problems after your
When the swelling started
If you’ve had severe swelling
in the past
What medicines you’re
What other health conditions
you have. These might be high blood pressure, heart disease, or diabetes.
You may need other tests to
diagnose lymphedema. These include imaging tests, measures of volume, and blood
Treatment for lymphedema
Treatment depends on how severe the
problem is. Treatment focuses on ways to help prevent and manage the condition. It
Exercise. Exercise helps improve lymph drainage. Your doctor, certified
lymphedema therapist, or physical therapist will recommend specific
Bandages. Wearing a compression sleeve or elastic bandage may help
to move fluid. It can also prevent fluid buildup.
Diet and weight management. Eating a healthy diet and controlling your
weight are an important part of treatment.
Elevation. Raising your arm above the level of your heart when possible
lets gravity help drain the fluid.
Preventing infection. It’s important to protect the skin in
the affected area from drying, cracking, infection, and skin breakdown.
Massage therapy. Massage by a certified lymphedema therapist can help
move fluid out of the swollen area.
Ask your healthcare provider for a referral to a certified lymphedema therapist. This
is a provider who
specializes in lymphedema teaching and management.
Working with your healthcare
Talk with your doctor about what
you can do to try to keep lymphedema from happening to you. Make these precautions
of your daily habits. Plan to follow them for the rest of your life.
Compare your hands and arms. Look
at them in the mirror. Learn what’s normal for you so you can notice changes right
If lymphedema does develop, let your doctor know right away. You can take steps to
to keep it from getting worse.