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Lymphedema After Breast Cancer

A diagnosis of breast cancer is difficult enough, even with the better outcomes commonly seen today. Yet after you have been successfully treated for breast cancer, you face another potential problem — lymphedema, a swelling that occurs in the arm, breast, or chest area after breast cancer treatment.

Lymphedema often occurs after lymph node removal, a fairly standard part of the breast cancer treatment process to see how far the cancer has spread.

Attached to those lymph nodes are networks of tiny lymph vessels that extend throughout the body and carry a watery fluid called lymph. When several lymph nodes and their lymph vessels are removed, the fluid has no place to go. It stays in the surrounding tissues, resulting in swelling.

Preventing lymphedema after breast cancer

Experts expect lymphedema to become less common in the future. This is because doctors are now doing more lumpectomies (removing just the cancerous portion of the breast) instead of mastectomies (removing the entire breast). New surgical techniques, such as sentinel lymph node biopsy, are also allowing doctors to remove the cancer without taking out as many lymph nodes.

Still, lymphedema is a real risk after breast cancer treatment, and you should take steps to try to prevent it. Here’s what can help:

  • Elevation. Two to 3 times a day, elevate the affected arm to reduce the risk of swelling. Doing this uses the force of gravity to make it harder for fluids to stay in the elevated arm. To do this, lie down and place your arm on pillows so that your hand is higher than your wrist and your elbow is higher than your shoulder. Your entire arm must be above the level of your heart. Do this for 45 minutes at a time.

  • Use your arm. Maintain good circulation in your affected arm by continuing to use it in normal ways, such as for brushing your teeth and hair, bathing, and eating.

  • Exercise your hand 3 to 4 times a day to minimize swelling. You can do this by holding your hand above the level of your heart and opening and closing the hand slowly 15 to 25 times.

  • Arm exercises. As soon as you can, start exercising your affected arm after surgery. You can usually begin in about a week, but talk with your doctor or physical therapist first to make sure it’s OK and to learn what kind of exercises are best for you.

  • Practice caution. Keep your affected arm clean and free of infections by doing your best to avoid any cuts, scrapes, or bites. If you do get an injury, clean and treat it thoroughly.

  • Moisturize. Use cream regularly to keep your hands, arms, and nails from drying out and cracking.

  • Offer your other arm for procedures. If you have to have blood drawn or need an injection or even a blood pressure check, have it done on your unaffected arm, if at all possible.

  • Avoid weather extremes. Avoid extreme cold, extreme heat, and any other situations that might irritate the affected arm or cause a burn.

  • Skip the heavy lifting. Although exercise is important, avoid exercising too vigorously or lifting heavy objects, including heavy purses and handbags. If you feel any strain or soreness in your arm, rest the arm. Although a recent study showed that a supervised program of light weightlifting might actually help prevent lymphedema, the women in the study were all at least 1 to 5 years past their breast cancer surgery. Most doctors still recommend avoiding weightlifting early on.

  • Keep it loose. Be sure that any clothing, jewelry, or gloves you wear on the affected arm or hand are as loose as possible to allow good circulation. Also wear a loose-fitting bra that doesn’t dig into your shoulders.

  • Flying. If you have to travel by air, especially if you do so often, ask your doctor if you should be fitted for a compression sleeve to prevent swelling during your flight.

Coping with lymphedema after breast cancer

Even if you take all of these precautions, lymphedema can still occur. If it does, it’s important that you try to reduce the swelling or keep it from getting worse, and prevent any complications, including infection.

Considering the risks involved, any signs or symptoms of lymphedema should be evaluated and treated by a trained health care specialist. This often can be done by a physical therapist with special training to help people with lymphedema.

The techniques that professionals use to manage lymphedema and get it under control might include a compression sleeve, special exercises, bandaging techniques, massage, and proper skin care.