Peer Review Status: Internally Reviewed by Cancer Center Staff
First Published: September 2003
Last Revised: June 2006

Swelling of the arm on the side of your breast cancer surgery can be due to the lymph nodes under the arm being removed or changed by radiation of the armpit.

After an injury anywhere in the body, lymph fluid will rush to the injured site to carry away bacteria and any foreign substances.  If that injured area is a hand or arm on the side of surgery and radiation, the lymph fluid will have a harder time being absorbed normally because surgery has removed some of the channels that would have carried the fluid.  Radiation has closed down some of those lymph channels also.  Since surgery and radiation were life saving treatments, the focus now should be on preventing injury and stress to the affected hand, shoulder and arm to lessen the chance of lymph fluid causing swelling of the arm.  If you are a person who has had armpit surgery to test lymph nodes for cancer cells, or if you have received radiation to the armpit, you may want to consider ways to prevent arm swelling.

• Avoid infection
• Avoid injury
• Avoid constriction
• Avoid muscle strain

AVOID INFECTION

• Treat even small injuries/hangnails with care.  Wash the injury with soap and water, apply antibiotic ointment, then cover with a band-aid.
• Keep skin of the hand and arm clean and moisturized.  Apply moisturizing lotion several times a day.

AVOID INJURY

• Do not have blood drawn from the affected arm, unless absolutely necessary.
• Wear long oven mitts whenever putting hands in an oven.  Have someone else get dishes out of the oven when feasible.
• Carefully cook foods in oil to avoid splashing of hot grease onto hands.
• Use rubber gloves when doing cleaning with harsh cleaners.
• Wear rubber gloves when doing dishes.
• Wear canvas gloves while gardening and doing yard work.
• Wear a thimble while sewing.
• Shave underarms with an electric razor.  Avoid chemical hair removers.
• Use insect repellant to protect against bug bites or bee stings.
• Avoid sunburn by using sunscreen with SPF of at least 15.  Reapply sunscreen after swimming and as directed on the sunscreen label.
• Don’t allow injections, vaccinations on the affected arm.
• Do not have manicures on the affected hand.  Do not cut cuticles or hangnails.
• Don’t hold a cigarette in the affected hand.

• Avoid clothing with elastic sleeve bands or with tight arms.
• Don’t wear a watch or rings on affected arm.
• Avoid carrying a heavy purse or bag with the affected arm.
• Have blood pressure taken on the unaffected arm, if possible.
• Underclothing, such as bras, should not leave pressure marks.
• When traveling in a car or plane for long distances, keep the affected arm above the level of the heart, if at all possible.

AVOID MUSCLE STRAIN

• Avoid heavy lifting if your muscles are not used to heavy lifting.
• Avoid vigorous, repetitive movements such as scrubbing, pulling, hammering.
• Use caution not to over use your arm during sports such as tennis, racquetball and golf.
• Begin any new exercise/activity involving the arms gradually and with caution.

AIR TRAVEL

Pressure changes in an airplane cabin may contribute to arm swelling.  As a precaution, contact your therapist or doctor about obtaining a compression sleeve prior to air travel

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