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​What is Lymphoedema?

Lymphoedema is an abnormal build up of protein-rich fluid in your body tissue. This leads to swelling of your body part and development of fibrosis (scarring of your tissues). It only impacts the area of your body affected by lymph node (the gland that helps your body to fight infections) removal or drainage.

What Causes Lymphoedema?


Illustration of our lymphatic system 

We are born with a system of lymphatic tissue under the armpits which normally drains lymph from your breast and your entire arms.
During your treatment for breast cancer, your lymphatic tissues may be damaged or partially removed during surgery and/or radiotherapy. This might lead to lymphoedema.
Lymphoedema is more common after an axillary clearance (removal of lymph nodes at the armpit) or with radiation treatment after axillary clearance. This may disrupt your body’s lymph drainage and cause swelling of your arms.
Lymphoedema occurs most often within three years of breast cancer treatment.

How do I Reduce My Risk of Developing or Worsening My Lymphoedema?

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  •  Do avoid cuts/injuries/scalding/burns to your affected arm.
  • Do wear long-sleeve clothing and apply insect repellent regularly to avoid insect bites and animal scratches.
  • Do treat all injuries to your affected arm with antiseptics and keep all wounds dry and clean.
  • Do wear gloves when gardening, doing household chores and washing with detergents.
  • Do gradually build up your duration and intensity of any activity or exercise.
  • Do take frequent rest periods during activity to allow limb recovery.
  • Do monitor your affected arm during and after activity for any change in size, shape, texture, soreness, heaviness, or firmness.
  • Do maintain a healthy weight.
  • Do make it a habit to raise your affected arm on a pillow before sleeping, as this helps to drain lymph fluid from your arm.
  • Do moisturise your skin regularly with a hand cream to prevent cracking of the skin.
  • Do seek medical advice when you need to travel long distances or when in doubt.

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  • Don’t use blades to remove your underarm hair. Use electric shavers or creams to remove unwanted hair instead.
  • Don’t cut cuticles when manicuring your nails.
  • Don’t allow any blood pressure taking, injections/punctures on your affected arm. (e.g. venepuncture, vaccinations or acupuncture.)
  • Don’t carry heavy items such as shopping bags or groceries with your affected arm, as too much strain will lead to arm discomfort and swelling.
  • Don’t lie on your affected arm while sleeping as it will compress the arm and prevent the flow of lymph fluid.
  • Don’t expose your affected arm to direct sunlight or heat for prolonged periods as high temperatures can easily damage the skin (e.g. avoid sun tanning, hot baths/showers and saunas.)
  • Don’t immerse your hands in water for prolonged periods.
  • Don’t wear tight and constrictive clothing, jewelleries and watch on your affected arm.
  • Don’t use forceful and repetitive movements with your affected arm (e.g. rubbing, scrubbing, pushing or pulling).
  • Don’t ignore any pain or swelling of your affected arm. Contact TTSH Breat Clinic or your Breast Care Nurse (BCN) immediately

Frequently Asked Questions

Q: How do I know if I have lymphoedema?
A: You may experience the following symptoms on the arm nearest to the surgical or radiation site:

  • Swelling, fullness of the arm
  • Heaviness and tightening of your jewelries and watch
  • Pain/cramps/aching sensation
  • “Pins and needles” sensation
  • Redness/heat sensitivity
  • Dryness and redness of your skin
  • Pus formation when your skin becomes infected

Q: When should I seek medical help?
A: Look out for the following warning signs of an infection so that you can seek prompt treatment:

  • Fever
  • Skin surface is warm or hot to touch
  • Skin redness
  • A change in the size of your arm, swelling of your arm
  • Increasing pain in your arm
  • Heaviness and aching when doing activities using your arm

If you have any concerns or questions, please contact TTSH Breast Clinic or your BCN.

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