- See also the information and Patient Handout on the Managing Symptoms & Side Effects page on Arm / Leg Lymphedema.
- This guide is designed to help you and your health care provider safely reduce and control the lymphedema in your arm. The goal of treatment is to make your arm less swollen, and to help make it continue to function normally.
- For health professional information on treating lymphedema, please see our Nursing Guidelines for Symptom Management.
- Lymphedema is a build-up of lymph fluid, usually in an arm or leg. Lymph fluid keeps our tissues free of infection. The fluid is filtered through lymph nodes (glands) in the armpit on its way to the blood stream.
- Some of the lymph nodes in the armpit are often taken out during breast cancer surgery. This is called axillary dissection and it’s done to see if there is any cancer in the lymph nodes. Another surgery is Sentinel Lymph Node dissection. Lymph nodes may be removed during surgery for other types of cancer, too. Testing the lymph nodes for cancer is a good way to see if the cancer has spread beyond the original site. Lymph node dissection occasionally changes or stops the free flow of lymph fluid. Patients develop lymphedema in the arm or leg, because lymph fluid can no longer leave the limb in the usual way.
- Most women with breast cancer don’t get lymphedema.
- The majority of women who develop arm lymphedema do so within 4 years of breast cancer treatment. If lymphedema develops, it is likely to be permanent, and only a few women will have temporary lymphedema.
- After axillary dissection (removal of underarm lymph nodes), the risk of lymphedema has been reported to be between 0% - 25%.
- The average rate is 3%, if there is no radiation therapy to the underarm area.
- With both axillary dissection and radiation therapy to the underarm area, the risk of lymphedema varies from 10 to 54%, with the average being 12%.
- The addition of regional radiation may increase the risk of arm swelling by 5 - 10%.
- Up to 16% of patients with other cancers are at risk of developing lymphedema, if they have had similar treatments such as lymph node removal with radiation therapy.
- There is currently no proven method to prevent lymphedema.
- Physiotherapy after surgery is helpful. Physiotherapists in BC who specialize in cancer patient care can be found on the
Physiotherapists of B.C. website.
- Will the lymphedema ever go away? About 7% of women who have had lymph nodes removed will develop some swelling of the arm after surgery, which is usually mild and goes away. Transient or temporary lymphedema can also show up years after surgery. It can be caused by infection or other reasons.
- Later lymphedema is of more concern because it may become permanent. Most patients who develop permanent lymphedema do so within 4 years of their breast cancer treatment, but it can also appear many years after surgery.
- Some risk factors for lymphedema can be managed. If you are concerned about lymphedema, there are things you can do to help:
- Maintain a healthy body weight
- Avoid injury to the affected limb (arm or leg).
- Watch closely for infections and report them to your healthcare provider.
- Regular, moderate exercise is also helpful.
- See the Follow up section in the Treatment tab above, for more details.
How do I know if I have lymphedema?
- You may be developing lymphedema if you notice that your hand is puffy or your arm feels heavy.
- Your sleeve, wristwatch or rings may leave deep impressions in your skin. As the lymphedema sets in, you may have pain in your arm as the backed-up fluid stretches the arm tissues and nerves. You may also experience pain in your upper back and shoulder because of the extra arm weight that these joints have to support. Report these symptoms to your doctor immediately.
- If your surgery was in the lower body, swelling may show in your leg or foot.
Swelling can result from other conditions. Your doctor may check to rule out other causes.