Lymphoedema after breast cancer treatment

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

Lowering your risk of lymphoedema

Sentinel lymph node biopsy

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

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

Heat and sunburn

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.

Looking after your arm

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

Exercises for arm lymphoedema

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. 

More information

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.

Visit EveryBodyCan