Lymphedema: A Guide for Women With Breast Cancer

What is Lymphedema?

Lymphedema is the swelling of a body part that occurs when the normal flow of the lymphatic system is changed. In breast cancer, this change occurs because of surgery on lymph nodes under the arm. Radiation treatment can also change the normal flow of the lymph system.When the normal flow is blocked or slows down, protein builds up in tissue spaces. This protein buildup pulls fluid from small blood vessels into the tissues. This extra fluid in the tissues is called edema.

How does the Lymphatic System work?

The lymphatic system is made up of large and small tubes (something like blood vessels) and groups of special tissues called lymph nodes and lymph fluid.

The job of the lymphatic system is:

• To return protein, cells, waste products and fluids to the blood stream
• To make white blood cells (called lymphocytes). White blood cells are important cells in the body’s immune system. The immune system is responsible for helping the body to fight infection.

Who Gets Lymphedema?

• The removal of lymph nodes from under the arm and/or
• Radiation to the underarm area

Other factors include:

• Number of lymph nodes removed during surgery
• Being overweight
• Injury to the arm that causes inflammation (redness, pain)

Any or all of these things may put you at risk for developing lymphedema.

When Does Lymphedema Occur?

Lymphedema can occur shortly after breast cancer treatment or several years later.

As long as you live, there is always the possibility of developing lymphedema. 

Lymphedema that occurs many years after treatment usually happens after an injury or trauma to the affected arm.

How Do I Know If I Have Lymphedema?

In the beginning stages of lymphedema, you may notice heaviness or fullness in the affected arm. Other possible signs of lymphedema in the affected arm include:

• tightness
• stiffness
• aching
• pain or discomfort
• redness

It is important to know that the arm that you usually use the most is always larger. This is also known as your “dominant” arm.

You should report any of these changes to your doctor as soon as possible.

Can I Prevent Lymphedema?

Looking after yourself is one of the most important ways of preventing lymphedema from occurring. You are less likely to experience lymphedema by:

• practicing proper arm exercises after surgery as explained by your physiotherapist
• learning to prevent injury
• following instructions about skin care

How Do I Protect My Arm?

To help prevent or control lymphedema and to protect your arm after treatment:

• carry packages or handbags on the other arm or shoulder
• avoid sunburns and burns to your affected arm and hand
• have shots (including chemotherapy), blood draws and blood pressure tests done in the other arm
• avoid cuts when shaving underarms; use an electric shaver
• wash cuts promptly, apply antibacterial medication and cover with a bandage.
• call your doctor if you think that you have an infection
• wear gloves to protect your hands when gardening and when using strong detergents
• avoid wearing tight jewelry on your affected arm; avoid elastic cuffs on blouses and nightgowns
• have careful manicures; avoid cutting your cuticles

The National Institute of Health suggests that women who are at risk for lymphedema take these precautions.