Living with breast cancer
Breast cancer treatment can cause a build up of lymph fluid. This is called lymphoedema and is pronounced lim-fo-dee-ma. Find out how you can lower your risk of getting it and how to manage it.
The lymphatic system carries clear watery fluid called lymph, which drains out from the small blood vessels (capillaries) into the body tissues.
Here is a short video to show you how the lymphatic system works:
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.
Find out more about what lymphoedema is and how it is diagnosed
Your surgeon might use a procedure called a sentinel lymph node biopsy (SLNB). This is when the surgeon removes the first lymph node (or first few lymph nodes). Removing the sentinel lymph nodes can cause damage to the lymph channels, so this can still cause lymphoedema. But the risk is much lower compared to removing most of the lymph nodes in the area.
Find out more about surgery to remove lymph nodes
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 protect your skin including:
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
using insect repellent and mosquito nets to prevent bites
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 straight away if it looks red or swollen. You might need antibiotics.
Find out more about infection and lymphoedema
Severe heat and sunburn can increase your risk of lymphoedema. There are things you can do to reduce your risk of sunburn or severe heat.
Spend time in the shade, especially between 11am and 3pm in the UK.
Wear suitable clothing to protect your skin from the sun such as long sleeved tops, trousers, long skirts and wide brimmed hats.
Wear a sunscreen with at least SPF 30 and 4 or 5 stars. Use it generously, reapply regularly and use together with shade and clothing.
Avoid very hot baths and showers, including saunas.
Take care of your skin by using a non scented moisturiser every day to keep your skin moist.
You'll get instructions on what exercises to do straight after surgery from your physiotherapist or specialist nurse. They’ll tell you what you can and can’t do after your type of surgery. You’ll have a programme that will gradually build up your arm movement and strength.
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. Let your team know straight away if you develop any swelling.
Read more about lowering your risk of lymphoedema
You should see your doctor or breast care nurse as soon as you can if you notice any swelling in your arm. Early signs and symptoms you might notice include your watch strap, rings or clothes feeling tighter. Your arm, hand or shoulder may ache or feel heavy, stiff, tight or have a feeling of fullness.
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, physiotherapist 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.
Find a lymphoedema practitioner
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.
When you’re sitting down, it helps to position yourself in a way that helps the lymph to drain.
You can help stop further swelling in your arm by positioning it carefully. Raise your arm to a comfortable level by putting it on a cushion or a pillow, but not above the height of your shoulder.
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.
The videos below show 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.
The first video shows deep breathing exercises. It is 1 minute long.
The next video is about arm exercises and is just over 4 minutes long.
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.
The Lymphoedema Support Network (LSN) has more information about exercises for arm lymphoedema.
Go to the Lymphoedema Support Network website
The British Lymphology Society (BSL) has a campaign called EveryBodyCan. It has information about lymphodema and activities you can do to keep your lymphatic system healthy.
Last reviewed: 04 Aug 2023
Next review due: 04 Aug 2026
Lymphoedema is swelling of a part of the body. It can be caused by some cancers and their treatment.
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