Find out about lymphoedema after breast cancer treatment, including how you can lower your risk of getting it and how to manage it.
Lymphoedema is pronounced lim-fo-dee-ma and means a build up of lymph fluid.
The lymphatic system carries clear watery fluid called lymph, which drains out from the small blood vessels (capillaries) into the body tissues.
Cancer or cancer treatment can affect the fluid drainage channels of the lymphatic system. Fluid then doesn't drain in the normal way, so the area swells.
About 1 in 5 people (20%) will have lymphoedema of the arm after breast cancer treatment that includes:
- surgery to remove lymph nodes
- radiotherapy to the lymph nodes
If lymphoedema is not treated, it may get worse. It can be painful and make it difficult to move your arm.
Lowering your risk of lymphoedema
Sentinel lymph node biopsy
Your surgeon might use a procedure called a sentinel lymph node biopsy (SLNB). They can just remove a few lymph nodes and avoid damaging lymph channels. This can lower your risk of developing lymphoedema.
Infection in a cut or graze can increase fluid collection in your arm and increase your risk of lymphoedema.
There are things you can do to help:
- wearing gloves when gardening or doing housework
- using nail clippers rather than scissors
- using an electric razor if you shave under your arms
- take care when playing with pets
If you get a cut or graze, wash it well and cover it up with a plaster or dressing until it's healed.
Go to your GP straightaway if it looks red or swollen. You might need antibiotics.
Heat and sunburnSevere heat sunburn can increase your risk of lymphoedema. You can:
- wear factor 50 sunscreen
- avoid very hot baths and showers
- use a non scented moisturiser every day to keep your skin moist
Looking after your arm
Putting too much strain on your arm after surgery can increase your risk of lymphoedema. Don't use your arm for anything heavy until your team say you can. You should carry on the arm and shoulder exercises you started after surgery.
You should see your doctor or breast care nurse as soon as you can if you notice any swelling in your arm. You might notice your watch strap, rings or clothes feeling tighter.
Treatment aims to reduce swelling and stop the fluid from building up again. The treatment can take a little while to show results.
You might have:
- an elastic sleeve to wear to reduce arm swelling
- an elasticated vest (to reduce breast swelling)
- your arm bandaged up with a particular type of short-stretch bandage that your lymphoedema specialist puts on
- exercises that help the fluid to drain from your arm
- a specialised massage called manual lymphatic drainage (MLD)
You might see a lymphoedema nurse specialist for these treatments. They will measure your arm and talk to you about your symptoms.
Your nurse or lymphoedema specialist can teach you how to do gentle exercises at home to help prevent or decrease swelling in your arm. You'll get the most benefit from the exercises by wearing your sleeve when you are doing the exercises.
Heavy lifting or too much repetitive exercise could make lymphoedema worse. So be sure to stop exercising if your skin is starting to become red, hot and sweaty.
It can be more difficult to control the swelling if you're overweight. Talk to the dietitian at the hospital or your GP if you would like some help with healthy eating tips or losing weight.
Some people with lymphoedema have said that spicy foods and alcohol can increase the swelling in their arm.
Positioning your arm
You can help stop further swelling in your arm by positioning it carefully. Rest your arm on the table or on cushions when you're sat down.
- Don't have blood taken from your affected arm.
- Don’t repeatedly stretch your arm – for example, by hanging out washing on a clothes line.
- Don't carry heavy shopping with your affected arm- ask for help even if it makes you feel uncomfortable.
- Wear your watch or jewellery on the other arm.
Exercises for arm lymphoedema
Your lymphoedema specialist will show you arm exercises you can do to help your lymphoedema. They can also be useful if you are at risk of developing it.
This video shows you how to do some exercises. Speak to your doctor or lymphoedema specialist if you are unsure about doing any of them and you should do them pain free. These videos were made with the lymphoedema team at University College Hospital London.
Arm exercises for lymphoedema
Hi I’m Carla, I’m going to show you some arm exercises.
Remember to repeat each exercise 5 to 10 times, to do your deep abdominal breathing before and after and its very important to be pain free.
We’ll start with the head and the neck. And I want you to turn your head to the side, back to the middle and to the other side, as much as possible. Back to the middle.
Now ear to the shoulder, keep your shoulders relaxed and your body straight and to the other side. It is normal that you might feel a bit of stretching on this exercise on the side of the neck.
Next one will be shoulders. Up, relax and down. And next one for the shoulders we’ll rotate them as much as possible, up, back and down. Backwards and then forward.
Now we’ll be doing combined movements. We’ll start on the knee, then touching the shoulder and up, going back to the shoulder and to the knee. If you have difficulties getting the arm as high as this, we’ll do it a bit lower. Then back to the shoulder and to the knee.
Another combination of movement will be pretend swimming. We’ll start with breast stroke and if this is painful on the shoulder, you’ll do it a bit lower.
Next one backstroke and if again you have problems with the shoulder you’ll do it a bit lower as well.
And the last one will be grabbing something that you can squeeze like a stress ball or a cushion and you’ll be pressing the hands together slowly. And this exercise is very good if you have any swelling of the breast area.
Next exercises will be the wrist. You can lean your forearm on an armchair or a table and what you’ll do is going up as much as possible and down as much as possible. Next one will be circles so one side first and going for the full movement and then the other side.
Next ones will be the hand and we will do opening as wide as possible your fingers, bending the fingers only by the knuckles, and then touching with your thumb each finger and try to do it as quick as possible. And the last one will be with the ball. So, you’ll be squeezing the ball five to ten times and you can do that as well opening your hand as wide as possible and doing a fist
Remember to do all the exercises once a day minimum without pain and if you’re concerned, see your doctor or speak to your lymphoedema specialist. Remember that you can find more information about lymphoedema on eth Cancer Research UK website.
Hi I’m Carla, I’m going to show you how to do deep abdominal breathing. Remember to have a nice posture, relaxed shoulders. You can do them sitting down or standing up. Remember to breathe in by nose and breathe out by mouth.
So, when you breathe in, imagine you have a balloon in your tummy and you inflate this balloon and when you breathe out, imagine you’re deflating this balloon. You need to feel your hand going in so we’ll do it together now. We’ll breathe in…. and out.
Remember to do them a maximum five times and before and after you do your lymphoedema exercises.
Watch our videos for the exercises of the area where you have lymphoedema or you’re at risk of lymphoedema.
You may feel very angry, upset and embarrassed by the swelling in your arm. After going through treatment for breast cancer, it may feel too much to cope with lymphoedema as well.
If your arm is very swollen, it can affect your self esteem. You might feel less attractive and find it harder to go out and socialise.
If you are feeling very upset and sad about what has happened, do let someone know. Talk to someone you trust. Make an appointment to see your lymphoedema specialist nurse.