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Avoiding Lymphedema After Lymph Node Dissection


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 extremity.


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 skin.

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 arm.

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 constricting.

10. Maintain an exercise program that includes walking, biking, or swimming.

11. Eat a well-balanced, protein-rich, low-salt diet.

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 therapy.

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