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Lymphedema After Breast Cancer Surgery

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How Is Lymphedema Diagnosed?

Lymphedema is diagnosed after a careful evaluation of your medical history, including past surgeries and treatments, an evaluation of current medications and symptoms, and a complete physical exam. Sometimes, additional tests may be needed.

How Is Lymphedema Treated?

Lymphedema treatments vary, depending on the stage and cause of the illness. The most important aspect of treatment is learning how to care for your general health. Your doctor or nurse should teach you how to follow your prescribed treatment.

If the initial signs and symptoms of swelling are caused by infection, antibiotics may be prescribed. Other treatments may include bandaging, proper skin care and diet, compression garments, exercises, and manual lymphatic drainage, a gentle form of skin stretching/massage.

How Can I Help Prevent Lymphedema?

Lymphedema can often be prevented or controlled by following these recommendations:

Maintain good nutrition

  • Reduce foods high in salt and fat.
  • Include at least two to four servings of fruits and three to five servings of vegetables in your daily meal plan.
  • Eat a variety of foods to get all the nutrients you need.
  • Use the package label information to help you to make the best selections for a healthy lifestyle.
  • Eat foods high in fiber such as whole-grain breads, cereals, pasta, rice, fresh fruits, and vegetables.
  • Drink plenty of water.
  • Maintain your ideal body weight. A registered dietitian or your health care provider can help calculate your ideal body weight.
  • Avoid alcoholic beverages.

Exercise regularly

  • Always check with a health care provider before starting a new exercise program.
  • To improve cardiovascular fitness, you should perform aerobic activities (including walking, swimming, low-impact aerobics, or specially prescribed exercises) for a total of 150 minutes a week.
  • Take time to include a five-minute warm-up before any aerobic activity, and include a 5-10-minute cool-down after the activity.
  • If your normal exercise routine includes upper body weight lifting, check with your health care provider about the best time to resume this activity, as well as any weight restrictions.
  • Discontinue any exercise that causes unexpected pain. If your arm on the side where you had surgery becomes tired during exercise, cool down, then rest and elevate it.

Avoid infections

  • Wear gloves while doing housework or gardening.
  • Avoid cutting your cuticles when manicuring your nails. Use care when cutting your toenails.
  • Frequently wash your hands with soap and warm water, especially before preparing food, and after using the bathroom or after touching soiled linens or clothes.
  • Protect your skin from scratches, sores, burns, and other irritations that might lead to infection. Use electric razors to remove hair and replace the razor head frequently.
  • Use insect repellents to prevent bug bites.
  • Immediately report any signs of infection to your health care provider.

Stay alert for these signs of infection:

  • Fever over 100.4 degrees F (38 degrees C)
  • Sweats or chills
  • Skin rash
  • Pain, tenderness, redness, or swelling
  • Wound or cut that won't heal
  • Red, warm, or draining sore
  • Sore throat, scratchy throat, or pain when swallowing
  • Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones
  • Persistent dry or moist cough that lasts more than two days
  • White patches in your mouth or on your tongue
  • Nausea, vomiting, or diarrhea
  • Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy"
  • Trouble urinating: pain or burning, constant urge, or frequent urination
  • Bloody, cloudy, or foul-smelling urine

Avoid tight clothing, shoes, or jewelry

  • Women should wear well-fitted bras; bra straps should not be too tight, avoid underwire styles, and wear pads under the bra straps if necessary. Wear comfortable, closed-toe shoes and avoid tight hosiery. Wear watches or jewelry loosely, if at all, on the affected arm.

Avoid heavy lifting with the affected arm

  • Avoid repetitive movements of the affected arm (such as scrubbing, pushing, or pulling). Do not carry a purse or bag on your shoulder (the side where you had surgery).

Keep your skin meticulously clean

  • Dry your skin thoroughly (including creases and between fingers and toes) and apply lotion.

Take precautions during visits to your health care provider

  • Ask to have your blood pressure checked on the unaffected arm. And avoid injections or blood drawing on the surgical side if possible.

Inform your health care provider of any symptoms

  • Notify your health care provider if you have redness, swelling, a skin rash, or blistering on the side of your body where you had surgery, or if you have a temperature greater than 100.4 degrees F (38 degrees C). These warning signs of infection could be an early sign of lymphedema and should be treated immediately.

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