Lymphedema is swelling that happens when lymph fluid can't drain normally. After breast cancer, it most often affects the arm on the side of surgery, but it can also show up in the hand, breast, chest, armpit or back. It can develop months or even years after treatment. Catching it early makes it much easier to treat, and early treatment can keep it from getting worse.
Why it happens
Surgery and radiation can remove or scar the lymph nodes under the arm that drain that area. Estimates vary, but roughly 1 in 5 people treated for breast cancer develop arm lymphedema. Your risk may be higher if you had:
Many lymph nodes removed (axillary node dissection) rather than a sentinel node biopsy
Radiation to the armpit or chest
An infection or injury in the arm after surgery
Extra weight, or significant weight gain after treatment
Early signs
Tell your doctor or therapist if you notice:
A heavy, full or tight feeling in your arm, hand, breast or chest
Rings, a watch, bracelets or a shirt sleeve feeling tighter on one side
Mild swelling that comes and goes, often worse at the end of the day
Tingling, aching, stiffness or reduced flexibility in the arm or shoulder
Skin that looks puffy or stays dented after you press on it
Veins on the back of your hand that are harder to see
Swelling doesn't have to be visible yet. Symptoms like heaviness or tightness alone are worth reporting.
Call your doctor right away if the area becomes red, warm or painful, or you have a fever. These can be signs of cellulitis, an infection that needs prompt treatment. Sudden, severe swelling also needs to be checked quickly.
What to do
Tell your doctor or cancer care team about any symptoms, even mild ones.
Ask for a referral to a certified lymphedema therapist (CLT). Many cancer centers offer measurement or screening programs that can find changes early.
Start treatment early. Early lymphedema often responds well to compression sleeves, exercise and self-care.
Protect your skin from cuts, burns and bug bites on the affected side.
Compression items that help
Compression is one of the main tools for keeping lymphedema under control. What you need depends on where the swelling is:
Arm: ready-to-wear or custom arm sleeve, or a sleeve with a built-in gauntlet (Jobst, Juzo, medi, Sigvaris)
Hand: a gauntlet, which covers the hand with fingers free, or a glove with or without fingertips (Jobst, Juzo, medi, Sigvaris)
Breast, chest and back: a compression bra or vest, with chip or foam pads for firm areas (Jobst, Sigvaris, Juzo, medi)
At night: a soft, low-stretch night garment or adjustable wrap (Jobst JoViPak, medi Circaid, Sigvaris, Juzo, L&R TributeNight)
Daily wear: donning gloves, donning aids and garment wash (Juzo, medi, Sigvaris)
If swelling keeps coming back even with garments, your doctor may prescribe a home compression pump. BioCompression pumps offer arm sleeves with shoulder and chest coverage for breast cancer–related lymphedema.
Get fitted by a professional
Compression for lymphedema should be prescribed by your doctor and fitted by a trained professional. The wrong size or pressure can make swelling worse, and a good fitting makes sure the garment helps instead of squeezing too tightly at the shoulder or wrist. Most daytime garments are worn while you're up and active; wear night garments only if your therapist recommends them.
At Midwest Compression, a Certified Compression Therapist measures and fits you in Richland, MI, serving patients from Kalamazoo, Battle Creek, Grand Rapids and Lansing. We work with your oncology team or lymphedema therapist on the prescription and check your benefits before anything is ordered. Call (800) 883-1549, text (517) 657-5223 or email customersupport@midwestcompression.com, or read how to care for your compression garments.
Helpful resources
This article is general information, not medical advice. Talk with your doctor, cancer care team or lymphedema therapist about any changes you notice.
