Lymphoedema after breast cancer treatment

This is usually mild, and develops gradually a few months or several years after treatment. Lymphoedema is more likely if you have had both surgery and radiotherapy to the underarm.

The lymph nodes and vessels normally help to remove lymph fluid from your arms. Removing them by surgery or irradiating them can block the flow of lymph. If this happens fluid will collect in the tissues under your skin making your hand and arm swell.

Sometimes swelling of the arm can occur after the initial surgery, but this usually goes back to normal within a few weeks and is not lymphoedema. If you’re concerned about any swelling, get it checked by your doctor or nurse.

The following suggestions can help to lower your risk of getting lymphoedema or lessen its severity if it does develop:

Protect the skin on your hand and arm

Keep your skin clean and dry and apply moisturising cream daily to keep it supple. Wear gloves and long sleeves when gardening to avoid being scratched. Protect your skin in the sun and avoid getting sunburnt.

Look after your hands

Wear gloves for DIY, washing up, household tasks and other tasks where you could cut or injure your hands, such as working on the car. Use nail clippers (not scissors) to cut your nails. Don’t push back or cut your cuticles.

Prevent infection in your hand and arm

Keep your arm clean. Don’t have needles put into your arm or hand, for example, to take blood or to give injections. If you get a graze or cut, treat it with antiseptic and keep it clean until it heals. Reduce the risk of getting insect bites by using insect repellent if there may be biting insects around. See your GP if there are any signs of infection such as redness, warmth or tenderness.

Avoid things that squeeze or constrict your arm

If you are having your blood pressure checked have the cuff put on your other arm. Avoid shoulder straps when carrying bags or briefcases. 

Avoid muscle strain

About six weeks after your operation you will be able to do most of your usual activities. It’s important to use your arm for normal, everyday things, but take a few precautions. Try not to overtire your arm. Use your unaffected arm or both arms to carry anything heavy. You may need to be more careful than before with some types of exercise, such as lifting weights. Ask your doctor, specialist nurse or physiotherapist for advice about what types of exercise are right for you.

Avoid temperature extremes

Test the temperature of water before bathing to make sure it’s not too hot. Don’t use saunas or hot tubs. Contact your nurse or doctor if you notice any swelling, redness, pain or heat in your hand or arm.

Lymphoedema can be improved with special massage techniques, exercises, bandaging and support sleeves. Many hospitals have a nurse or physiotherapist who specialises in treating lymphoedema. The earlier treatment is started, the more likely it is to be successful, so let your doctor know if you notice even mild swelling of your hand or arm.

You can see our section on lymphoedema| for information on its causes, how to manage it, and what to look for.