Table of ContentsView AllTable of ContentsPain After MastectomyPreventing LymphedemaTreatmentFinding a Physical TherapistFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Pain After Mastectomy
Preventing Lymphedema
Treatment
Finding a Physical Therapist
Frequently Asked Questions
If they become clogged, damaged, or are removed as part of a surgery, like amastectomy(breast removal surgery), fluid can build up and cause swelling, known aslymphedema.
Learn more about identifying lymphedema after amastectomy, prevention, treatment, and getting support for the condition.
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Identifying Lymphedema Pain After Mastectomy
Both the location where pain and swelling occurs and the timing of symptom progression can vary.
Location
Arm swelling typically occurs closest to the site where the lymph nodes were removed during a mastectomy. However, swelling in other areas, like the chest or midsection, is also possible. Other lymphedema-related symptoms may include:
Timing of Symptom Progression
Lymphedema can occur any time after mastectomy surgery in which the lymph nodes are damaged or removed. Some people experience lymphedema within days to weeks after the surgery, which usually goes away on its own.
However, it’s more common for people to develop swelling over time, typically 18 to 24 months following surgery. In this case, lymphedema does not improve or go away, and treatment is needed.
Around 30% to 47% of people who undergo a mastectomy and an axillary lymph node dissection to remove lymph nodes experience lymphedema after surgery. This number could be even higher for those who also undergoradiation therapy.
Diagnosis
There is no single test that indicates a positive diagnosis for lymphedema. Your healthcare provider will ask you about your medical history, recent surgeries, when you noticed the swelling, if you’ve experienced swelling before, or if you have any other health conditions.
They may also run imaging or blood tests.Your healthcare provider may want to rule out other potential causes of swelling, such ascancer recurrenceordeep veinthrombosis(DVT).
Other Conditions and Treatments That Increase Lymphedema RiskSeveral other conditions and treatments can lead to lymphedema beyond mastectomy-related removal or damage of the lymph nodes. These include:ObesityPelvic surgeriesTumors that block lymph nodesKidney diseaseRadiation therapyLack of physical activity
Other Conditions and Treatments That Increase Lymphedema Risk
Several other conditions and treatments can lead to lymphedema beyond mastectomy-related removal or damage of the lymph nodes. These include:ObesityPelvic surgeriesTumors that block lymph nodesKidney diseaseRadiation therapyLack of physical activity
Several other conditions and treatments can lead to lymphedema beyond mastectomy-related removal or damage of the lymph nodes. These include:
Postmastectomy Steps to Prevent Lymphedema
There are several recommended behaviors to help reduce the risk of lymphedema. These include:
Generally, getting medical checkups, taking care of your skin, and incorporating healthy lifestyle behaviors, such as eating a nutritious diet, getting enough quality rest, and gradually engaging in physical activity, are risk-reducing recommendations.
Newer surgical techniques during mastectomy procedures have also been introduced to help prevent lymphedema. These techniques aim to repair or redirect the flow of lymph fluid to reduce the likelihood of swelling.
Lymphedema May Occur Regardless of Prevention StrategiesUnfortunately, researchers have not yet established why some people develop lymphedema. It’s also unclear why certain factors, including removal of lymph nodes, radiation therapy, and highbody mass index (BMI), may contribute to its development.Further, the recommended prevention strategies are based on the clinical experience of lymphedema experts rather than on strong evidence of their effectiveness.
Lymphedema May Occur Regardless of Prevention Strategies
Unfortunately, researchers have not yet established why some people develop lymphedema. It’s also unclear why certain factors, including removal of lymph nodes, radiation therapy, and highbody mass index (BMI), may contribute to its development.Further, the recommended prevention strategies are based on the clinical experience of lymphedema experts rather than on strong evidence of their effectiveness.
Unfortunately, researchers have not yet established why some people develop lymphedema. It’s also unclear why certain factors, including removal of lymph nodes, radiation therapy, and highbody mass index (BMI), may contribute to its development.
Further, the recommended prevention strategies are based on the clinical experience of lymphedema experts rather than on strong evidence of their effectiveness.
Early diagnosis of lymphedema can lead to quicker treatment, fewer symptoms, and better quality of life. However, no treatment, including surgery, can cure the condition.
Combineddecongestivetherapy (CDT) is typically how lymphedema is treated. It combines several techniques and is completed in two phases.
Short-Term Treatments
Phase one of CDT treatment involves intensive support from a trained professional, including a physical, occupational, or massage therapist. This phase includes the following techniques:
Ongoing Treatment
Phase two of CDT treatment is the maintenance phase, which involves performing self-manual lymphatic drainage, wearing compression garments, exercising at home, and properly caring for your skin. These practices can help reduce swelling and pain and improve your quality of life.
For some people, surgery may be necessary, though it does not cure the condition. Surgical procedures remove excess fat, tissue, or skin resulting from the swelling. It may also redirect the way the lymph fluid drains in the body.
How to Find a Lymphedema Physical Therapist
Your healthcare provider may recommend that you work with a physical or occupational therapist to address your lymphedema. Request a referral to a certified lymphedema specialist. It’s also wise to check with your health insurance to determine whether the specialist and therapy services are covered before making an appointment.
Summary
Lymphedema is a common condition resulting from damaged or removed lymph nodes during a mastectomy that creates fluid buildup. It occurs when lymph fluid can’t drain properly, resulting in swelling, pain, and limited use of the arm, chest, or midsection. Your healthcare provider will ask about previous surgeries, swelling, or other health conditions to diagnose the condition.
Prevention strategies include avoiding breaks in the skin or constriction of the affected area, wearing compression garments, and avoiding extreme temperatures. However, it is still possible to develop lymphedema after breast cancer surgery.
Lymphedema is typically treated with combined decongestive therapy (CDT), which involves techniques to reduce swelling and pain. Some may require a surgical procedure, but neither surgery nor CDT will cure the condition.
A Word From Verywell
If you are experiencing swelling after breast cancer surgery, speak with your healthcare provider. Treating lymphedema early can reduce your risk of future damage and infection and increase your quality of life and ability to manage the condition.
Lymphedema after breast cancer surgery is common. It often develops in the arm but can also affect your midsection or chest. Lymphedema affecting the arm after breast cancer surgery occurs in about 21.4% of cases. Swelling due to lymphedema in the midsection has an incidence of about 10% and around 14% in the chest.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Lymphedema.UpToDate.com.Patient education: lymphedema after cancer surgery (beyond the basics).Johns Hopkins Medicine.Breast cancer: lymphedema after treatment.Lipman K, Luan A, Stone K, et al.Lymphatic microsurgical preventive healing approach (lympha) for lymphedema prevention after axillary lymph node dissection—a single institution experience and feasibility of technique.J Clin Med. 2021;11(1):92. doi:10.3390/jcm11010092Natinal Health Services United Kingdom.Lymphoedema causes.McLaughlin SA, Bagaria S, Gibson T, et al.Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery.Journal of the American College of Surgeons. 2013;216(3):380-389. doi:10.1016/j.jamcollsurg.2012.11.004National Lymphedema Network.Risk reduction practices.Cemal Y, Pusic A, Mehrara BJ.Preventative measures for lymphedema: separating fact from fiction.J Am Coll Surg. 2011;213(4):543-551. doi:10.1016/j.jamcollsurg.2011.07.001Sayegh HE, Asdourian MS, Swaroop MN, et al.Diagnostic methods, risk factors, prevention, and management of breast cancer-related lymphedema: past, present, and future directions.Curr Breast Cancer Rep. 2017;9(2):111-121. doi:10.1007/s12609-017-0237-8Hahamoff M, Gupta N, Munoz D, et al.A lymphedema surveillance program for breast cancer patients reveals the promise of surgical prevention.Journal of Surgical Research. 2019;244:604-611. doi:10.1016/j.jss.2017.10.008National Lymphedema Network.Lymphedema therapy.Mobarakeh ZS, Mokhtari-Hesari P, Lotfi-Tokaldany M, et al.Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema.Support Care Cancer. 2019;27(10):3805-3811. doi:10.1007/s00520-019-04681-9National Lymphedema Network.Surgical treatment options.American Cancer Society.People with lymphedema.Abouelazayem M, Elkorety M, Monib S.Breast lymphedema after conservative breast surgery: an up-to-date systematic review.Clinical Breast Cancer. 2021;21(3):156-161. doi:10.1016/j.clbc.2020.11.017Tan C, Wilson CM.Clinical outcomes after physical therapy treatment for secondary lymphedema after breast cancer.Cureus. 11(5):e4779. doi: 10.7759/cureus.4779National Lymphedema Network.Signs and symptoms of lymphedema.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Lymphedema.UpToDate.com.Patient education: lymphedema after cancer surgery (beyond the basics).Johns Hopkins Medicine.Breast cancer: lymphedema after treatment.Lipman K, Luan A, Stone K, et al.Lymphatic microsurgical preventive healing approach (lympha) for lymphedema prevention after axillary lymph node dissection—a single institution experience and feasibility of technique.J Clin Med. 2021;11(1):92. doi:10.3390/jcm11010092Natinal Health Services United Kingdom.Lymphoedema causes.McLaughlin SA, Bagaria S, Gibson T, et al.Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery.Journal of the American College of Surgeons. 2013;216(3):380-389. doi:10.1016/j.jamcollsurg.2012.11.004National Lymphedema Network.Risk reduction practices.Cemal Y, Pusic A, Mehrara BJ.Preventative measures for lymphedema: separating fact from fiction.J Am Coll Surg. 2011;213(4):543-551. doi:10.1016/j.jamcollsurg.2011.07.001Sayegh HE, Asdourian MS, Swaroop MN, et al.Diagnostic methods, risk factors, prevention, and management of breast cancer-related lymphedema: past, present, and future directions.Curr Breast Cancer Rep. 2017;9(2):111-121. doi:10.1007/s12609-017-0237-8Hahamoff M, Gupta N, Munoz D, et al.A lymphedema surveillance program for breast cancer patients reveals the promise of surgical prevention.Journal of Surgical Research. 2019;244:604-611. doi:10.1016/j.jss.2017.10.008National Lymphedema Network.Lymphedema therapy.Mobarakeh ZS, Mokhtari-Hesari P, Lotfi-Tokaldany M, et al.Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema.Support Care Cancer. 2019;27(10):3805-3811. doi:10.1007/s00520-019-04681-9National Lymphedema Network.Surgical treatment options.American Cancer Society.People with lymphedema.Abouelazayem M, Elkorety M, Monib S.Breast lymphedema after conservative breast surgery: an up-to-date systematic review.Clinical Breast Cancer. 2021;21(3):156-161. doi:10.1016/j.clbc.2020.11.017Tan C, Wilson CM.Clinical outcomes after physical therapy treatment for secondary lymphedema after breast cancer.Cureus. 11(5):e4779. doi: 10.7759/cureus.4779National Lymphedema Network.Signs and symptoms of lymphedema.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Lymphedema.UpToDate.com.Patient education: lymphedema after cancer surgery (beyond the basics).Johns Hopkins Medicine.Breast cancer: lymphedema after treatment.Lipman K, Luan A, Stone K, et al.Lymphatic microsurgical preventive healing approach (lympha) for lymphedema prevention after axillary lymph node dissection—a single institution experience and feasibility of technique.J Clin Med. 2021;11(1):92. doi:10.3390/jcm11010092Natinal Health Services United Kingdom.Lymphoedema causes.McLaughlin SA, Bagaria S, Gibson T, et al.Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery.Journal of the American College of Surgeons. 2013;216(3):380-389. doi:10.1016/j.jamcollsurg.2012.11.004National Lymphedema Network.Risk reduction practices.Cemal Y, Pusic A, Mehrara BJ.Preventative measures for lymphedema: separating fact from fiction.J Am Coll Surg. 2011;213(4):543-551. doi:10.1016/j.jamcollsurg.2011.07.001Sayegh HE, Asdourian MS, Swaroop MN, et al.Diagnostic methods, risk factors, prevention, and management of breast cancer-related lymphedema: past, present, and future directions.Curr Breast Cancer Rep. 2017;9(2):111-121. doi:10.1007/s12609-017-0237-8Hahamoff M, Gupta N, Munoz D, et al.A lymphedema surveillance program for breast cancer patients reveals the promise of surgical prevention.Journal of Surgical Research. 2019;244:604-611. doi:10.1016/j.jss.2017.10.008National Lymphedema Network.Lymphedema therapy.Mobarakeh ZS, Mokhtari-Hesari P, Lotfi-Tokaldany M, et al.Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema.Support Care Cancer. 2019;27(10):3805-3811. doi:10.1007/s00520-019-04681-9National Lymphedema Network.Surgical treatment options.American Cancer Society.People with lymphedema.Abouelazayem M, Elkorety M, Monib S.Breast lymphedema after conservative breast surgery: an up-to-date systematic review.Clinical Breast Cancer. 2021;21(3):156-161. doi:10.1016/j.clbc.2020.11.017Tan C, Wilson CM.Clinical outcomes after physical therapy treatment for secondary lymphedema after breast cancer.Cureus. 11(5):e4779. doi: 10.7759/cureus.4779National Lymphedema Network.Signs and symptoms of lymphedema.
Centers for Disease Control and Prevention.Lymphedema.
UpToDate.com.Patient education: lymphedema after cancer surgery (beyond the basics).
Johns Hopkins Medicine.Breast cancer: lymphedema after treatment.
Lipman K, Luan A, Stone K, et al.Lymphatic microsurgical preventive healing approach (lympha) for lymphedema prevention after axillary lymph node dissection—a single institution experience and feasibility of technique.J Clin Med. 2021;11(1):92. doi:10.3390/jcm11010092
Natinal Health Services United Kingdom.Lymphoedema causes.
McLaughlin SA, Bagaria S, Gibson T, et al.Trends in risk reduction practices for the prevention of lymphedema in the first 12 months after breast cancer surgery.Journal of the American College of Surgeons. 2013;216(3):380-389. doi:10.1016/j.jamcollsurg.2012.11.004
National Lymphedema Network.Risk reduction practices.
Cemal Y, Pusic A, Mehrara BJ.Preventative measures for lymphedema: separating fact from fiction.J Am Coll Surg. 2011;213(4):543-551. doi:10.1016/j.jamcollsurg.2011.07.001
Sayegh HE, Asdourian MS, Swaroop MN, et al.Diagnostic methods, risk factors, prevention, and management of breast cancer-related lymphedema: past, present, and future directions.Curr Breast Cancer Rep. 2017;9(2):111-121. doi:10.1007/s12609-017-0237-8
Hahamoff M, Gupta N, Munoz D, et al.A lymphedema surveillance program for breast cancer patients reveals the promise of surgical prevention.Journal of Surgical Research. 2019;244:604-611. doi:10.1016/j.jss.2017.10.008
National Lymphedema Network.Lymphedema therapy.
Mobarakeh ZS, Mokhtari-Hesari P, Lotfi-Tokaldany M, et al.Combined decongestive therapy and reduction of pain and heaviness in patients with breast cancer-related lymphedema.Support Care Cancer. 2019;27(10):3805-3811. doi:10.1007/s00520-019-04681-9
National Lymphedema Network.Surgical treatment options.
American Cancer Society.People with lymphedema.
Abouelazayem M, Elkorety M, Monib S.Breast lymphedema after conservative breast surgery: an up-to-date systematic review.Clinical Breast Cancer. 2021;21(3):156-161. doi:10.1016/j.clbc.2020.11.017
Tan C, Wilson CM.Clinical outcomes after physical therapy treatment for secondary lymphedema after breast cancer.Cureus. 11(5):e4779. doi: 10.7759/cureus.4779
National Lymphedema Network.Signs and symptoms of lymphedema.
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