If you are wondering about lymphedema after breast surgery, you are not alone in asking. It is swelling caused by a buildup of lymph fluid, and it may arise soon after treatment or years later.
This page explains what lymphedema is, who is at higher risk and how it is generally managed. The wider recovery picture is covered in the hub on life after breast cancer surgery.
| Item | In plain language |
|---|---|
| What it is | Swelling from a buildup of lymph fluid between skin and muscle |
| Link to breast surgery | Treatment often removes underarm nodes, increasing the risk |
| Where it may appear | Hand, arm or chest on the treated side |
| Sentinel node biopsy | Removes fewer lymph nodes, decreasing the risk |
| When it may start | Soon after treatment, or years later; most often slowly |
| Can it be cured? | It is chronic and cannot be cured, but can be treated |
These points come from the National Cancer Institute. Medical information can change, so please check the source for the latest details.
What lymphedema is
The National Cancer Institute describes lymphedema as swelling caused by a buildup of lymph fluid in the body between the skin and muscle. Lymph fluid is part of the lymph system, which plays a role in the body’s ability to fight infection and disease. When cancer or its treatment disrupts the flow of that fluid, it can collect and cause swelling.
The American Cancer Society explains the idea with an analogy. Removing lymph nodes is like closing lanes on a highway: cars cannot get through as easily and traffic slows down. Lymph fluid, like the cars, starts to back up and causes swelling in the body parts that those lymph nodes drain.
Why it can follow breast surgery
Breast cancer treatment often involves the underarm area. The National Cancer Institute says that treatment for breast cancer often involves surgery that removes one or more lymph nodes in the underarm area, which increases the risk of lymphedema. A person treated with radiation therapy or surgery may develop it in the hand, arm or chest on the side where lymph nodes were removed or damaged.
The amount of surgery matters. The American Cancer Society says that the more lymph nodes removed, the higher the risk. It states that a sentinel node biopsy usually removes 2 or 3 lymph nodes, while an axillary node dissection usually removes between 5 and 30 lymph nodes from the armpit.
The National Cancer Institute adds that advances in surgery are helping to reduce the chances of lymphedema, because sentinel lymph node biopsy lets doctors remove fewer lymph nodes when checking whether cancer has spread. The effect of radiation on the same area is covered in the guide to radiation therapy and breast reconstruction.
Surgery is not the only route. The National Cancer Institute says that cancer treatments can cause lymphedema when surgery disrupts the flow of lymph fluid and when radiation therapy causes scar tissue that blocks the flow of lymph fluid.
The American Cancer Society adds that lymphedema can occur when the lymph system is damaged or does not work properly, and it lists infection and injury among the other factors that can increase the risk. For someone who has had breast surgery, this is why the care team often talks about skin care and protecting the arm on the treated side, and why questions about everyday activities are worth raising at follow-up visits.
Timing and risk factors
Lymphedema does not follow one schedule. According to the National Cancer Institute, it may arise soon after cancer treatment or develop years after treatment has ended, and most often it develops slowly over months or years. The American Cancer Society likewise notes that it can develop many years after treatment, even in a person who has never had it before.
Risk depends on more than the operation. The National Cancer Institute lists other risk factors, including having an infection, healing slowly after surgery, having lymph nodes removed, past surgeries or radiation, having advanced cancer, and being overweight or having obesity. It recommends talking with a doctor to learn about individual risk, which is the right place to get an assessment that general information cannot provide.
Signs to watch for
Because lymphedema can develop gradually, the National Cancer Institute advises paying close attention to slight changes. Signs and symptoms it lists include a heavy, full or tight feeling in the area where surgery or radiation took place, swelling, and numbness or tingling in the affected area. In an arm, other signs can include swelling that makes it look larger than the other arm, difficulty moving it, and weakness.
The same page notes that lymphedema is easier to control when treatment starts early, so people are advised to contact their doctor as soon as they notice heaviness, swelling or other signs. A change in sensation after surgery is not automatically lymphedema, since tingling and tightness are also common healing effects, as described in the guide to pain after breast surgery. The care team is the right contact for telling the two apart.
How lymphedema is managed
The National Cancer Institute states that once lymphedema develops it is a chronic condition that cannot be cured, but it can be treated to relieve swelling and improve a person’s ability to function day to day. Its page explains that the health care team discusses management techniques that can be done at home or under the supervision of a trained professional, such as a nurse or a certified lymphedema therapist.
Approaches described there include compression garments, manual lymphatic drainage, which it describes as gentle massage that helps move lymph fluid through the body, and a compression pump. Complete decongestive therapy, managed by a certified lymphedema therapist, may also include bandaging, exercises and skin care. Which approaches suit a given person is a decision for the treating team.
Lowering risk and living with it
The National Cancer Institute says there is no way to prevent lymphedema, but there are things that can lower the risk or keep it from getting worse. It notes that a health care team may suggest protecting the skin to prevent infection, exercising, and wearing compression garments as advised by a therapist. It also suggests that anyone concerned should ask the care team questions, including which changes to look for and which ones to call about.
Living with lymphedema can have emotional effects as well. The National Cancer Institute says the physical changes can affect well-being, that a person may not be able to do activities once enjoyed or find clothes that fit properly, and that some people feel uncomfortable with how they look or isolated from others. Raising these concerns with the care team is part of normal follow-up.
Decisions about monitoring, prevention and treatment belong with the reader’s own surgeon and care team, who know which lymph nodes were treated and what other treatment was given. Ask them what to expect and what to do if swelling appears.
Frequently asked questions
Can lymphedema appear years after surgery?
Show answer
Yes. Authoritative cancer information says it may appear soon after treatment or years afterwards, and that it usually develops slowly.
Does having fewer lymph nodes removed lower the risk?
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Cancer organisations report that risk rises with the number of lymph nodes removed, and that sentinel node biopsy, which removes fewer nodes, can reduce the chances compared with fuller removal.
Is lymphedema curable?
Show answer
It is described as a chronic condition without a cure, but it can be treated to relieve swelling and help a person function day to day.
Who should be told about new swelling or heaviness?
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The doctor or care team. Early contact is advised because lymphedema is easier to control when management starts early.
