Lymphoedema

What is lymphoedema?

Lymphoedema is swelling caused by a build-up of lymph fluid in the surface tissues of the body. Following treatment for breast cancer this lymph fluid build-up may occur as a result of damage to the lymphatic system because of surgery and/or radiotherapy to the lymph nodes (glands) in the armpit (axilla) and surrounding area. Sometimes it can be caused by cancer cells blocking the lymph system.

If you think you have developed lymphoedema, it is important to contact your breast care nurse or specialist team for an assessment. The sooner you are treated, the better the outcome may be.

What physical symptoms might I have?

Swelling

Swelling often happens in the arm or chest area immediately after breast surgery. This is part of the healing process and may settle in a short time without any treatment.

You should get advice from your breast care nurse or a member of your specialist team as soon as possible if:

• your arm, hand or breast area is swollen for more than a few weeks after surgery
• the swelling develops later on
• the swelling develops after your breast cancer treatment is completed,.

Swelling in the arm, hand or finger(s) can occur on the side of the body on which you had your operation or radiotherapy. Swelling can also develop in the breast or chest wall, on the affected side, following treatment.  Your breast may feel heavy and you may notice dents left by your bra on the skin (breast oedema). This can be uncomfortable and sometimes painful.

A well-fitting bra with wide straps and side pieces can help to support the breast and ease some of the discomfort. If your arm or breast is red, inflamed and painful, contact your GP as you may have an infection and need antibiotics.

Tightness

The arm can feel tight when there is extra fluid in the tissues. Some people feel tightness in the arm without the arm appearing swollen. Gentle exercise can relieve these feelings.

Dry skin

Where there is swelling, the skin becomes stretched, and can become dry, flaky and itchy, and prone to infection. Try to keep the skin clean by washing gently, avoiding soaps that dry out the skin. Dry your arm and hand thoroughly after washing and use an unperfumed moisturising cream to help keep the skin supple and moist. This will help protect the skin and ease these symptoms.

Arm stiffness

If your arm is swollen, it may limit movement in the joints. It is important to exercise your arm and shoulder regularly in order to reduce stiffness and encourage lymph drainage. If you were given specific exercises after your surgery or radiotherapy it is vital to continue doing them for as long as recommended.

Discomfort

Most people will experience some level of discomfort with lymphoedema. Many people complain of a tight, heavy feeling in the arm and the discomfort tends to be dull and vague. Discomfort often occurs after strenuous activity. Try doing some gentle exercise. When you are sitting, rest your arm on a pillow or cushion but not so that it is above the height of your shoulder. Pain relief such as paracetamol can sometimes help.

Infection

If your arm or chest suddenly becomes red, tender and hot, with increased swelling or a rash, you may have developed an infection. This is called cellulitis. You may also have flu-like symptoms, which can sometimes be the first sign of an infection. These symptoms need urgent attention from your GP and you will probably need to start taking a course of antibiotics straight away.

If you have repeated infections you may be prescribed a low-dose antibiotic to take continuously.

Where can I go for treatment?

In many cases the breast care nurse at your hospital will be able to help and advise you about mild lymphoedema. If you have swelling for some time or it is associated with other symptoms, you may need to be referred to a lymphoedema clinic for more specialist treatment and advice.

If you would like to find out where your nearest clinic is, contact your doctor, breast care nurse or telephone our Helpline on 0808 800 6000 (textphone 0808 800 6001). We have a directory of clinics throughout the country and can give you details on how to contact them. 

 

Content last reviewed March 2012; next planned review 2013