For women at risk for lymphedema
At this time, it’s not clear if lymphedema can be prevented. Still, most experts say following these basic steps might lower your risk of lymphedema, delay its onset, or reduce its impact:
Get regular medical check-ups.
Regular check-ups should include checking for lymphedema. If you’ve been recording arm measurements, this may be part of the check-up. Talk to your cancer care team about how often you should be checked.
Don’t avoid mammograms.
At this time, there’s no link between mammograms and the start of or worsening of lymphedema. Mammograms are a key part of breast cancer follow-up and should not be avoided because of worries about lymphedema. If you do notice breast swelling or soreness after a mammogram, be sure to talk to your doctor or lymphedema therapist.
Report any changes.
After surgery, you’ll learn how your arm, chest, and breast normally feel. Tell your cancer care team about any changes in size, color, temperature, feeling, or skin condition right away.
Try to get to and/or stay at a healthy weight.
We know that obese women are at higher risk for lymphedema. Talk to your cancer care team about what a healthy weight is for you. Get their advice on how to get to or stay at that weight.
It’s important to use your affected arm for normal, everyday activities to help you heal properly and regain strength. This includes doing things like brushing your hair and bathing. Using your muscles helps drain lymph fluid from your arms. It also helps keep your muscles flexible and helps reduce scarring.
Certain types of exercise can help reduce your lymphedema risk, too. In fact, avoiding exercise and allowing your arm to get out of shape may lead to lymphedema and bouts of swelling that are sometimes called flare-ups.
That said, it’s important to know that some kinds of exercise can increase your risk of lymphedema or make lymphedema worse if you already have it. Work with a trained fitness or health professional to design an exercise plan that starts at a low level of intensity and progresses slowly to ensure that you avoid overuse, which is bad for the lymph system.
If you’ve had surgery or radiation, ask your cancer care team when you can start to exercise and what type of exercises you can do. But keep in mind that overuse, which can lead to injury, has been linked to the start of lymphedema in some women. It’s a good idea to follow these tips:
- Use your affected arm as normally as you can. Once you are fully healed, about 4 to 6 weeks after surgery or radiation, you can begin to go back to the activities you did before your surgery. But check with your cancer care team first.
- Exercise regularly, but try not to over-tire your shoulder and arm. Before starting any exercises, talk with your doctor, nurse, or physical therapist. They can help you set goals and limits so that you work at the level of activity that’s right for you.
- If your arm starts to ache, lie down and raise it above the level of your heart.
- Avoid vigorous, repeated activities.
- Avoid heavy lifting or pulling.
- Use your unaffected arm or both arms to carry heavy packages, groceries, handbags, or children.
Talk to your doctor or another health professional about exercise before starting any kind of workout.
Use of compression garments
Compression garments are fitted sleeves that can help control lymphedema. They can help prevent or reduce swelling by moving lymph fluid from the arm back into the body. Careful fitting is needed, and you should follow your health care professional’s advice on use and care of the garment.
Compression garments are most often used by women who already have lymphedema. But if you’re at risk for lymphedema, you might want to use one to help lower your risk in certain situations. For instance, lymphedema has been linked with air travel, possibly because of air pressure changes, but there are pros and cons to using a compression garment on long or frequent airplane flights. Ask your doctor or therapist if you should be fitted for a sleeve to wear during air travel. You might also want to discuss ways to safely raise your arm above the level of your heart and exercise it during long flights.
Do not use a poorly fitting sleeve under any circumstances. This may increase your risk for or worsen lymphedema.
You usually don’t need a compression garment to prevent lymphedema during exercise. But if you’ve noticed swelling while exercising, talk to your doctor or therapist.
Try to avoid infection.
Your body responds to infection by sending extra fluid and white blood cells to fight the infection. If lymph nodes and vessels are missing or damaged, it’s harder for your body to move this extra fluid, which can trigger or worsen lymphedema. Good hygiene and careful skin care may reduce your risk of lymphedema by helping you avoid infections. Follow these tips to care for the hand and arm on the side of your body that had surgery or radiation:
- Have your blood drawn, IVs, and shots done in your unaffected arm if you can. Also get flu shots and vaccinations in your unaffected arm or somewhere else, like the hip. Tell the doctor or nurse that you’re at risk for lymphedema.
- Keep your hands and cuticles soft and moist by regularly using moisturizing lotion or cream. Push your cuticles back with a cuticle stick rather than cutting them with scissors.
- Keep your arm clean. Clean and protect any skin breaks caused by cuts, scratches, insect bites, hangnails, or torn cuticles. See “How to care for cuts, scratches, or burns” in the section called “Take care of yourself.”
- Wear protective gloves with sleeves when doing household chores that use harsh chemical cleansers or steel wool, when gardening or doing yard work, and when working with animals that might scratch or bite.
- Wear a thimble when sewing to cut down on needle and pin pricks to your fingers.
- Be extra careful when shaving your underarms, and use a clean razor on clean skin.
- Use an insect repellent to help prevent bug bites when outdoors. If you’re bit or stung on the affected arm, clean and put ice on the area and raise the arm. Keep it clean, and call your cancer care team if the bite or sting shows any signs of infection.
- Do what you can to protect yourself against falls and fractured bones.
Be aware of cellulitis.
Cellulitis is an infection in the tissues just under your skin. Signs and symptoms of this problem include redness, warmth, fever, pain, and flu-like symptoms. This is an urgent medical problem that you need to tell your doctor about right away.
Cellulitis can lead to or worsen lymphedema. In fact, if it becomes a repeated problem, antibiotics may be needed to keep it under control.
Try to avoid burns and extreme temperatures.
Like infections, burns can cause extra fluid to build up and cause swelling when lymph nodes have been removed or damaged. To avoid burns:
- Protect your chest, shoulders, and arms from sunburn. Cover these areas with tightly woven clothing, or use a broad-spectrum sunscreen labeled SPF 30 or higher. Try to stay out of the direct sun between the hours of 10 a.m. and 4 p.m., when the ultraviolet (UV) rays are strongest.
- Use oven mitts that cover your lower arms.
- Be careful when frying foods, boiling liquids, and removing food from a microwave oven.
- Avoid high heat, such as from hot tubs and saunas. If you use a heating pad or ice pack on the affected areas, limit the length of time you use it until you know how your body responds. Both heat and cold can damage tissues and increase fluid build-up. Some doctors may advise you to stay away from all sources of extreme temperatures.
Try to avoid constriction.
Constriction or squeezing of the arm may increase the pressure in nearby blood vessels. This can lead to increased fluid and swelling (much like water building up behind a dam). Some women have linked this with the start of lymphedema. Tips include:
- Wear loose jewelry, clothing, bras, and gloves. Avoid anything that fits too tightly or puts pressure around your chest, arm, or wrist. Be sure compression garments fit well and are worn properly. Clothing and compression garments should be supportive and have smooth, even compression.
- Do not use shoulder straps when carrying briefcases and purses.
- Wear a loose-fitting bra with padded straps that don’t dig into your shoulder. Make sure underwires don’t put pressure on your breast or chest. After a mastectomy, use a lightweight prosthesis (breast form). A heavy prosthesis might put too much pressure on the area.
- Have your blood pressure taken on the unaffected arm, if possible. If both arms are affected, blood pressure can be taken on your thigh. Or, you can ask that blood pressure be measured by someone using a hand pump and stethoscope rather than using a machine; the machines often use high pressures for a longer time.
Last Medical Review: 07/10/2015
Last Revised: 07/10/2015