Reducing your risk of lymphoedema

The short version

  • Most people who have lymph nodes removed don’t develop lymphoedema, but your risk is higher after lymph node surgery and radiotherapy to the armpit.1, 2
  • Keep your arm moving and stay active. Exercise, including slowly progressed weight training, does not increase the risk of lymphoedema.3, 4
  • Look after your skin on the treated side, and know the early signs so you can get help quickly.1

Who is at risk?

Lymphoedema is swelling caused by lymph fluid building up when lymph nodes have been removed or damaged. About 1 in 5 people develop arm lymphoedema after breast cancer, most within two years. The risk is about four times higher after removal of lymph nodes from the armpit (axillary clearance) than after sentinel node biopsy alone.2

Your risk is higher if you’ve had:1

  • surgery and radiotherapy to the lymph nodes
  • more lymph nodes removed
  • an infection (cellulitis) in the arm on that side
  • limited movement in your arm and shoulder

Being overweight also raises the risk.1

The lymph nodes in the armpit drain fluid from the arm, breast and chest.

Keep moving

People used to be told to protect the arm and avoid lifting. The evidence now shows that’s not necessary:

  • In a trial of 154 women at risk of lymphoedema, slowly progressed weight training did not increase the risk. Among women who’d had five or more lymph nodes removed, lymphoedema was less common in the weight-training group (7%) than in those who didn’t train (22%).3
  • International guidelines confirm that exercise does not make lymphoedema worse.4

What helps:1

  • do your arm and shoulder exercises after surgery, to keep good movement. See arm and shoulder exercises
  • return to your usual activities gradually, building up over time
  • stop if you notice discomfort or swelling, and get it checked
  • unless you regularly lift heavy things, ask for help with very heavy shopping, luggage or furniture at first

Look after your skin

Infections can trigger lymphoedema, so caring for the skin on your treated side really matters:1

Skin care for the treated arm: moisturise daily, wear gloves for gardening and washing up, use sunscreen, and use insect repellent.
  • moisturise every day to stop the skin drying and cracking
  • wear gloves for gardening, washing up and handling hot dishes
  • use high-factor sunscreen
  • use insect repellent containing at least 50% DEET
  • take care with shaving, nails and cuticles
  • clean cuts and grazes straight away and use antiseptic cream
  • drink enough fluids, as dehydration can make skin dry

Common questions

Should I avoid blood tests or blood pressure checks on that arm?

There’s no consistent evidence that injections, blood tests, blood pressure checks or drips in the arm on the treated side cause lymphoedema. You may still prefer to use your other arm, and it’s fine to ask.1

Is flying safe?

Yes. There’s no evidence that flying causes lymphoedema. On long journeys, clench and unclench your fists and shrug your shoulders from time to time. There’s no evidence that wearing a compression sleeve on a flight prevents swelling, and a badly fitting sleeve can cause problems.1

Should I keep to a healthy weight?

Yes. Being overweight increases the risk, so keeping to a healthy weight is one way to lower it.1

Know the early signs

Contact your breast care nurse or team as soon as possible if you notice:1

  • swelling, tightness, heaviness or aching in your arm, hand, fingers, breast or chest on the treated side
  • rings, a watch or your bra feeling tighter than usual

Contact your GP or team urgently if the area becomes red, hot or painful, or you have flu-like symptoms. This could be an infection (cellulitis) that needs antibiotics.1

Prefer a guided plan?

A personalised rehabilitation programme can help you rebuild strength gradually and safely after surgery, with lymphoedema risk taken into account. See how digital rehabilitation works.

Related pages

Everyone’s treatment is different, so talk to your cancer team about what is right for you.

References

  1. Breast Cancer Now. Reducing the risk of lymphoedema (BBC15). www.breastcancernow.org/media-assets/4icd5jsj/bbc15-reducing-the-risk-of-lymphoedema-web-pdf.pdf
  2. DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncology. 2013;14(6):500–515. doi.org/10.1016/S1470-2045(13)70076-7
  3. Schmitz KH, Ahmed RL, Troxel AB, et al. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA. 2010;304(24):2699–2705. doi.org/10.1001/jama.2010.1837
  4. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise. 2019;51(11):2375–2390. doi.org/10.1249/MSS.0000000000002116