Lymphedema After Breast Cancer: What You Can Do to Stay Ahead of It
Lymphedema is swelling that can happen when lymph fluid builds up in an area of the body. For many people who've gone through breast cancer treatment, it's a common side effect, especially if lymph nodes were removed or radiation was part of care. In fact, about 1 in 5 breast cancer survivors develop lymphedema.
The good news? There are simple, science-backed ways to lower your risk.
Newer research, combined with clinical expertise, has helped update breast cancer-related lymphedema (BCRL) risk-reduction recommendations. In this blog post, we'll break down some outdated advice that's been debunked and strategies to reduce your risk of developing BCRL.
Why Reducing Your Lymphedema Risk Matters
Lymphedema can impact your range of motion, function, and daily life. It may start with mild swelling but can worsen over time if not managed early. That's why prevention and early detection are key. Historically, guidelines for decreasing the risk of developing BCRL have been cautious (sometimes too cautious and restrictive), and some advice was based more on tradition than science. With updated research, we now have better information to help you stay informed and empowered in your care.
1. Early and Regular Check-Ups
One of the most important strategies is early and ongoing screening, also called prospective surveillance. This means getting baseline measurements (like arm volume or bioimpedance testing) before treatment begins and having regular follow-ups afterward. Why is this helpful? Small changes in swelling can be detected early before symptoms are even noticed. Early treatment during this "subclinical" stage can help prevent more advanced stages of lymphedema.
If you're about to start breast cancer treatment, talk to your medical team about setting up baseline measurements and ongoing monitoring with a Certified Lymphedema Therapist.
2. Exercise Is Not Only Safe—It's Encouraged
You may have heard outdated advice like, "Don't lift more than 10 or 20 pounds." But research tells a different story: exercise is not just safe, it's good for you! That includes aerobic exercise like walking or swimming and resistance training like lifting weights. Exercise helps promote lymphatic flow, improves strength and cardiovascular function, and decreases the risk of lymphedema onset.
The key to exercise is progression. Start with light resistance and gradually increase your activity. People living with and beyond cancer should aim for 2–3 days of strength training per week and 150 minutes of moderate or 75 minutes of vigorous-intensity aerobic activity each week. If you're staying consistent, you can typically progress your resistance or program about every two weeks.
With guidance from a knowledgeable oncology physical or occupational therapist, you can rebuild your strength and endurance safely and confidently while reducing your risk of developing lymphedema. Already have lymphedema? Exercise can help reduce swelling, but make sure you wear compression garments!
Ready to get started with your exercise program?
Check out my YouTube Breast Cancer Survivorship Playlist for mobility and strengthening routines designed specifically for breast cancer survivors.
3. What About Blood Pressure and Needles in the Affected Arm?
You've probably heard this: "Never get your blood pressure taken or have blood drawn on the at-risk arm." However, current research shows that a single blood pressure reading or injection in the affected arm does not significantly raise lymphedema risk. That said, repeated pressure or trauma to the arm (like frequent blood draws or prolonged IV infusions) may still increase risk. So, when possible, use the unaffected arm. But if it's unavoidable, don't panic; monitor for swelling in the following days and reach out to your care team if you notice changes.
4. Prioritize Skin Care
Infections like cellulitis are known triggers for lymphedema onset and worsening. Here are some key recommendations to take care of your skin and reduce this risk:
Moisturize daily and avoid perfumes/fragrances in your moisturizer which can dry out or irritate the skin
Use sunscreen, sun-protective clothing, and insect repellent when outdoors
Clean and protect wounds, scratches, or bites right away
Watch for signs of infection, such as redness, warmth, pain, increased or new swelling in the area, or flu-like symptoms. If you notice these, get medical care immediately.
5. Should You Wear a Compression Garment to Prevent Lymphedema?
Not everyone needs to wear compression sleeves to prevent lymphedema. But if you're at high risk (for example, if you've had multiple lymph nodes removed during surgery), they may help prevent the onset of lymphedema. Your healthcare team or certified lymphedema therapist can help determine if prophylactic (preventive) compression is right for you.
6. Air Travel and Lymphedema Considerations
The myth that air travel causes lymphedema because of pressurized cabins isn't supported by strong evidence. If you've never had lymphedema and are considered low risk for developing it, you probably don't need to wear a compression sleeve when flying. But if you already have lymphedema or your risk is higher, wearing a compression garment during flights can be helpful. As always, check with your lymphedema therapist for personalized advice before your trip.
Already have lymphedema? Read my blog post, How to Manage Lymphedema While Traveling for tips!
7. Hot Environments and Saunas
Living in a hot climate won't necessarily increase your lymphedema risk, but temporary swelling can happen in the heat. Hot climates include hot showers, saunas, hot and humid weather, and intense workouts in warm conditions like hot yoga. If you're at high risk, limit your time in saunas and hot tubs, stay hydrated, and monitor for swelling. Again, it's about knowing your body and adjusting based on how you feel.
Remember: Every breast cancer survivor's risk of lymphedema is different. Your cancer treatment history, lifestyle, and genetics all play a role. That's why individualized care is so important. If you're concerned about lymphedema or just want to be proactive, consider working with a certified lymphedema therapist (CLT). They can guide you through prevention, monitoring, and early treatment strategies tailored to your needs.
⭐️ Want a comprehensive e-guide and tracking guide for your lymphedema? Download my FREE Cancer Survivor’s Guide to Lymphedema E-Guide.
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