Removal of the lymph nodes
beneath the arm is often performed with mastectomy and as
a part of lumpectomy and radiation therapy. When these
lymph nodes are removed or when the patient has radiation
to the axilla (armpit), they are forever susceptible to
developing swelling or lymphedema of the arm on that
side. This can occur months to years after therapy and
the patient has to be vigilant in protecting this
1. Keep your arm elevated above your
heart whenever possible.
2. Keep your arm clean and lubricate
the skin daily. Especially in the dry winter months,
lubrication is important to prevent cracking of the
3. Avoid injury of the extremity. Even
trivial trauma or insect bites can lead to cellulitis or
lymphangitis (red streaks spreading up the arm). Wear
gardening and cooking gloves when working in these areas.
Wear thimbles when sewing and prevent paper cuts when
filing papers. Any injury should be cleaned and treated
with an antibacterial ointment and if there is any
question about infection, you may need to take an oral
antibiotic. Don't hesitate to call your surgeon or
primary care physician.
4. If you shave the hair beneath your
arms, use an electric razor.
5. Maintain good nail care and avoid
cutting your cuticles.
6. When going for health checks, avoid
blood pressure measurements in that arm, avoid finger
sticks, blood draws, vaccinations and I V lines on the
side of the axillary lymph node removal.
7. Avoid prolonged or strenuous
exercise of the affected extremity. Strenuous physical
exercise of the arm can aggravate edema of the arm. Range
of motion exercises, however, will maintain good function
of the arm.
8. Avoid exposing the arm to extremes
of heat or cold. Avoid sunburn with gradual tanning or
protective clothing. Avoid ice packs and heating pads, as
well as saunas, steam rooms, and hot tubs. The latter can
be a source of bacterial infection as well as the heat
can induce swelling and aggravate edema of the
9. Avoid clothes or objects that
constrict or impair blood return from the arm. A heavy
purse hanging at the elbow can act as a partial
tourniquet and restrict the blood flow back to the heart.
Wear loose jewelry and avoid bracelets that might be
10. Maintain an exercise program that
includes walking, biking, or swimming.
11. Eat a well-balanced, protein-rich,
12. Be vigilant in watching for signs
of infection (redness, pain, warmth, swelling, fever) and
contact your physician immediately should this occur.
Prevention is the best treatment. If you feel that your
arm is beginning to swell, call us and T.S.S. would be
glad to assist you in getting started with appropriate