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Lumpectomy and mastectomy breast surgery can cause a change in the way lymph fluid flows which can result in uncomfortable and possibly unsightly swelling (known as lymphedema). Radiation treatment can also cause lymphedema.

Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. It usually develops slowly over time. The swelling can range from mild to severe. It can start soon after surgery or radiation treatment. It can also begin months or even many years later. 

There are ways that you can care for your arm and breast area to reduce your chances of getting lymphedema. Once lymphedema has started, it cannot be cured. After it goes away, it can come back. There are steps you can take to reduce symptoms and help keep it from getting worse.

For additional information, see:

What Is The Lymph System?

Our bodies have a network of lymph (limf) nodes and lymph vessels that collect watery, clear lymph fluid, much like veins collect blood from all parts of the body and carry it through the body. Lymph fluid contains proteins, salts, and water, as well as white blood cells, which help fight infections. In the lymph vessels, valves work with body muscles to help move the fluid through the body. Lymph nodes are small collections of tissue that work as filters for harmful substances and help us fight infection.

diagram of the network of lymph nodes and vessels

The network of lymph nodes and vessels

What Is Lymphedema?

During surgery for breast cancer, the doctor removes at least one lymph node from the underarm area to see if the cancer has spread. Sometimes doctors remove more than one. When lymph nodes are removed, the lymph vessels that carry fluid from the arm to the rest of the body are also removed because they are wrapped around the nodes.

Removing lymph nodes and vessels changes the way the lymph fluid flows in that side of the upper body. This makes it harder for fluid in the chest, breast, and arm to flow out of this area. If the remaining lymph vessels cannot drain enough of the fluid from these areas, the excess fluid builds up and causes swelling, or lymphedema. Radiation treatment to the lymph nodes in the underarm can affect the flow of lymph fluid in the arm and breast area in the same way, further increasing the risk of lymphedema.

Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. It usually develops slowly over time. The swelling can range from mild to severe. It can start soon after surgery or radiation treatment. But it can also begin months or even many years later. Women who have many lymph nodes removed and women who have had radiation therapy to the breast and/or underarm area may have a higher risk of getting lymphedema.

Doctors still do not fully understand why some patients are more likely to have problems with fluid build-up than others. They expect that in the future fewer women will develop lymphedema because

  • breast surgery and treatment keep getting more conservative (that is, more women are treated with lumpectomy);
  • research advances have led to methods like the sentinel lymph node biopsy (a newer procedure which allows the surgeon to remove only 1 or 2 lymph nodes); and
  • newer studies are looking at finding which lymph nodes drain the arm before surgery so they can be preserved when possible. This procedure is called axillary reverse mapping.

There is still much to be learned about lymphedema, but there are ways that you can care for your arm and breast area to reduce your chances of having future problems. Once lymphedema has started, it cannot be cured. But early and careful management can reduce symptoms and help keep it from getting worse.

Key Points To Keep In Mind About Lymphedema

The following is a self-quiz to help you remember some of the important areas covered here. Try taking the quiz, then look at the answers below. If you have any questions or something is not clear, talk to your doctor or nurse.

1. To help prevent and control long-term swelling, remember hand and arm precautions:

a. for 6 weeks after surgery 
b. for 6 months after surgery 
c. until your doctor says you have developed new lymph pathways 
d. until you feel fine 
e. forever

2. To prevent infection in the affected arm:

a. cut your cuticles every week 
b. wear gloves when working with hot or sharp objects 
c. use an electric shaver 
d. stay out of bright sunlight 
e. b and c only

3. If swelling appears in the affected arm or hand soon after surgery:

a. raise the arm for 45 minutes 
b. call your doctor or nurse right away 
c. raise and support your hand or arm above the level of your heart, then open and close your hand 15 to 25 times 
d. a and c only 
e. a, b, and c

4. Call your doctor or nurse:

a. if the affected breast, hand, arm, or underarm (axilla) feels hot or is red or swollen 
b. if you have a temperature over 100.5 ' F 
c. if you want to shave your underarm with an electric shaver 
d. a and b only 
e. a, b, and c


  1. e -- Forever. Remember these precautions to help protect your arm and reduce your risk of ever getting lymphedema.
  2. e -- Wear gloves when working with hot or sharp objects. Use an electric shaver to prevent skin injury. Use a sunblock (SPF of 15 or higher) to prevent sunburn. Do not cut your cuticles; use lotion and a cuticle stick instead.
  3. d -- a and c only. Raise and support your arm for 45 minutes and open and close your hand 15 to 25 times. Repeat this 2 to 3 times.
  4. d -- a and b only. Call your doctor or nurse if you have symptoms that might mean an infection, such as if the affected arm or underarm feels hot or is red or swollen, or if you have a fever that is not related to a cold or flu.

How To Reduce Swelling After Surgery Or Radiation

Right after surgery, the affected arm or breast area may swell. This swelling is usually short-term and slowly goes away over the next 6 to 12 weeks. These tips may help ease the swelling during this time:

  • Use your affected arm as you normally would to do things like comb your hair, bathe, dress, and eat.
  • Raise your affected arm above the level of your heart 2 or 3 times a day and keep it there for 45 minutes. Lie down to do this, and fully support your arm. Put your arm up on pillows so that your hand is higher than your wrist and your elbow is a little higher than your shoulder.
  • Exercise your affected arm while it is supported above the level of your heart by opening and closing your hand 15 to 25 times. Repeat this 3 to 4 times a day. This exercise helps reduce swelling by pumping lymph fluid out of the arm through the undamaged lymph vessels.
  • To get back your normal shoulder and arm movement, begin exercising your affected arm about a week after your surgery. But talk to your doctor, nurse, or physical therapist before doing any exercises. For most people, normal range of motion returns within 4 to 6 weeks.
  • If you have radiation therapy after surgery, it may cause arm swelling or make the swelling last longer than it normally would after surgery. It may also cause some swelling in the chest and breast toward the end of the treatment. In most cases, this swelling is short-term and will slowly go away. During treatment and up to 18 months afterward, you should do simple stretching exercises each day to keep full movement in your chest, arm, and shoulder.

How To Prevent And Control Lymphedema


Lymphedema is an accumulation of lymph fluid that may cause swelling in a nearby limb such as an arm or a leg (and sometimes elsewhere in the body). When the lymph fluid is unable to drain, it remains in the soft tissue of the lymph node or area where infections can develop.

New medical techniques make lymphedema less likely to appear than previously. Still, it is advisable to do what you can to avoid lymphedema. It is uncomfortable and can also be unsightly.

Lymphedema can come and go. Once you experience it, it is likely to recur. There is no cure for lymphedema.

There are no scientific studies to show how lymphedema can be prevented. However, most experts agree that following the following basic guidelines from the American Cancer Society offsite link may lower your risk of developing lymphedema or delay its onset. For information about each guideline, click on the link.

If you believe you have lymphedema, call your doctor immediately. The treatment he or she will recommend will be primarily based on the cause of the lymphedema. Untreated, the condition can result in permanent swelling.

For more information about Lymphedema, see the website of National Lymphedema Network at offsite link or call 415.908.3681

NOTE: Lymphedema does not indicate that cancer has spread or returned.

More information about this subject is contained in the Main Article in "To Learn More."

To Learn More

How To Care For Cuts, Scratches, Or Burns

  • Wash the area with soap and water.
  • Put an antibiotic cream or ointment on the area.
  • Cover with a clean, dry gauze or bandage.
  • For burns, apply a cold pack or cold water for 15 minutes, then wash with soap and water and put on a clean, dry dressing.
  • Watch for early signs of infection: pus, rash, red blotches, swelling, increased heat, tenderness, chills, or fever.
  • Call your doctor right away if you think you may have an infection.

To Learn More

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Signs Of Lymphedema

The signs of lymphedema may include:

  • swelling in the breast, chest, shoulder, arm, or hand
  • area feels full or heavy
  • skin changes texture, feels tight or hard, or looks red
  • new aching or discomfort in the area
  • less movement or flexibility in nearby joints, such as your shoulder, hand, or wrist
  • trouble fitting your arm into jacket or shirt sleeves
  • bra doesn't fit the same
  • ring, watch, and/or bracelet feels tight but you have not gained weight

Early on, the lymphedema may be relieved by raising the affected limb and the skin usually stays soft. But over time, the swollen area may become hot and red and the skin hard and stiff.

If you have had any type of breast surgery, lymph nodes removed, or radiation treatment, look at your upper body in front of a mirror. Compare both sides of your body and look for changes in size, shape, or skin color. If you notice any of the signs listed above, and if they last for 1 to 2 weeks, call your doctor or nurse.

When To Call Your Doctor Or Nurse

  • If  you notice any swelling, with or without pain, that lasts for 1 to 2 weeks
  • If any part of your affected arm, chest, breast, or underarm area (axilla) feels hot, looks red, or swells suddenly. These could be a sign of infection and you may need antibiotics
  • If you have a temperature of 100.5 'F or higher (taken by mouth) that is not related to a cold or flu
  • If you have any new pain in the affected area with no known cause 

Lymphedema Treatment

If you are diagnosed with lymphedema, there are treatments to reduce the swelling, keep it from getting worse, and decrease the risk of infection. The treatment is prescribed by your doctor and should be given by an experienced therapist. Be sure to check your health insurance to make sure the treatment is covered.

Mild lymphedema should be treated by a physical therapist or other health care professional who has gone through special training. Moderate or severe lymphedema is most often treated by a therapist with special training and expertise who will help you with skin care, massage, special bandaging, exercises, and fitting for a compression sleeve. This is sometimes known as complex decongestive therapy, or CDT. Manual lymphatic drainage, or MLD, is a type of massage used along with skin care, compression therapy, and exercise to manage lymphedema.

Although most insurance companies will pay for lymphedema treatment, some do not cover the cost of compression garments and dressings. Check with your insurance company about coverage for these therapies.

Seeking and getting treatment early should lead to a shorter course of treatment to get your lymphedema under control.

Take Care Of Yourself

Taking care of your whole body is important. Eat well and get to and stay at a healthy weight. Try to eat 5 or more servings of vegetables and fruits each day. Choose whole-grain foods instead of white flour and sugars. Try to limit meats that are high in fat. Cut back on processed meats like hot dogs, bologna, and bacon. If you drink alcohol, limit yourself to 1 or 2 drinks a day at the most. And don't forget to get some type of regular exercise. A good diet and regular exercise can help you stay at a healthy weight and give you more energy. Try to reduce the stress in your life and get enough sleep, too.

You also need people you can turn to for strength and comfort. Support can come in many forms: family, friends, cancer support groups, church or spiritual groups, online support communities, or one-on-one counselors. You may want to get support from others with lymphedema. It helps to talk to people who understand what you're going through. Call American Cancer Society offsite link at 800.ACS.2345 or contact the National Lymphedema Network (see the "Additional Resources" section below) to find support groups in  your area. 

You can't change the fact that you have lymphedema. What you can change is how you live your life -- taking good care of yourself, making healthy choices, and doing what you can to make your body and your mind feel as good as possible.

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Additional Resources

Lymphedema: Understanding and Managing Lymphedema After Cancer Treatment is a book you can buy from your American Cancer Society offsite link. Please call 1-800-ACS-2345 for cost and ordering information.

National organizations and Web sites*

Along with your American Cancer Society offsite link, other sources of information and support include:

Lymphology Association of North America (LANA) 
Telephone: 773-756-8971 (Illinois) 
Web site: offsite link
Web site lists therapists, nurses, and physicians who specialize in treating lymphedema.

National Lymphedema Network (NLN) 
Toll-free number: 1-800-541-3259 

Web site: offsite link
Susan G. Komen for the Cure 

Toll-free number: 1-877-465-6636 
Web site: offsite link

 Breast Cancer Network of Strength 

Toll-free number: 1-800-221-2141 (English);1-800-986-9505 (Spanish) 
Web site: offsite link

*Inclusion on this list does not imply endorsement by the American Cancer Society or Survivorship A to Z, Inc.