Lymphedema After Mastectomy: Pain Management Tips

Lymph fluid, a component of the body's immune system, helps fight illness by carrying cells and fluid to address infections. Lymph nodes throughout the body act as drains.

If they become clogged, damaged, or are removed as part of a surgery, like a mastectomy (breast removal surgery), fluid can build up and cause swelling, known as lymphedema.

Learn more about identifying lymphedema after amastectomy, prevention, treatment, and getting support for the condition.

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:

• New pain following breast cancer surgery
• Weakness or trouble bending your arm at the joints
• A full or heavy feeling
• Skin that appears tough or thick
• Tingling or numbness
  
• Changes in the way your clothing or jewelry fits
  

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.

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 as cancer recurrence or deep vein thrombosis (DVT).

Postmastectomy Steps to Prevent Lymphedema

There are several recommended behaviors to help reduce the risk of lymphedema. These include:

• Avoiding breaks or cuts in the skin, such as blood draws or needle sticks
• Avoiding constriction of the affected area, like blood pressure cuffs
• Avoiding extreme hot or cold temperatures
• Using compression garments, especially while traveling

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.

Treatment

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.

Combined decongestive therapy (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:

• Manual lymphatic drainage: A practice that lightly stretches and massages the skin in the affected area to allow lymph fluid to absorb and drain
• Skin care education: Including how to keep the area moisturized and clean and how to address breaks or cuts in the skin to avoid infection
  
• Low-intensity exercises: Gets muscles pumping and allows fluid to move
• Use of pneumatic devices: Applies pressure to the affected area to encourage fluid movement and decongestion
• Compression bandages: Supports the affected area to control swelling

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.