Arms feel heavy after breast cancer surgery, beware of lymphedema!

Author: You Miaoning, deputy chief nurse, Peking University Cancer Hospital

Reviewer: Duan Hua, Chief Physician, Beijing Obstetrics and Gynecology Hospital, Capital Medical University

Research data in my country show that the incidence of lymphedema after breast cancer surgery is around 10%-50%, which is related to lymph node dissection during breast cancer surgery.

We know that many lymphatic vessels pass through the armpit, where many lymph nodes gather.

The final circulation point of the human body's lymphatic system is at the jugular angle. Inside the jugular angle, there is a final convergence point of the lymphatic and venous vessels. Through this convergence point, the lymph fluid can flow back to the veins.

Figure 1 Original copyright image, no permission to reprint

Therefore, after breast cancer surgery, if the axillary lymph nodes are cleared, the lymph transport pathway may be blocked and there will be no normal circulation to the venous system, causing lymphedema in the upper limbs.

In the early stages of postoperative lymphedema after breast cancer surgery, the patient may suddenly feel that the arm on the side where the surgery was performed is a little heavier, swollen, or numb than before. However, there may be no swelling at this time.

At this time, it is very necessary to actively seek medical treatment.

Because lymphedema after breast cancer surgery must be detected, diagnosed and treated early, if this situation is found, it is recommended that patients go to a professional clinic for lymphedema diagnosis and treatment as soon as possible for early diagnosis.

If it is determined that the patient has lymphedema, early intervention should be carried out to allow the affected side to get sufficient rest, and then further observation should be carried out.

In addition to swelling, there are some other manifestations of lymphedema after breast cancer surgery.

For example, when lymphedema is accompanied by inflammation, there will be redness, swelling, heat and pain on the skin. The skin surface will turn red and feel hot when touched. The patient may also complain of pain in the skin.

Some patients may develop fat swelling as edema worsens, meaning their arms are not hard but very soft, with a large lump hanging down. In the late stage, the pores of the skin may become enlarged and thickened, or the skin may become darker.

If the edema becomes increasingly severe, tissue fibrosis will also occur. Tissue fibrosis means hardening. When you press on it, the affected limb will feel stiff and will lose the elasticity of normal skin.

Especially the hands, the function of the hands will be affected and may cause disability. If the shoulder or elbow joints become stiff, it will also cause limited movement, such as limited abduction and flexion, which is what we call disability.

Therefore, it is very important to prevent lymphedema after breast cancer surgery.

To prevent lymphedema after breast cancer surgery, we must take into account all aspects of food, clothing, housing and transportation.

First of all, when it comes to dressing, the clothes on the affected side should not be too tight, and don’t wear tight jewelry. Many patients wear very tight bracelets or rings on their hands, and you can see the marks, so try not to wear them.

In fact, eating well means trying to control your weight. Obesity increases the incidence of lymphedema, which is the result of foreign and domestic research. So you should pay attention to your diet and avoid eating too greasy food that easily increases weight.

When you are at home, be careful not to do certain actions.

In daily housework, such as mopping the floor, patients are advised not to do it repeatedly. If they must mop the floor, try to take a break after mopping for five minutes, and do not mop the entire house at once, because this repetitive labor may damage the lymphatic vessels.

Making dumplings, rolling out dumpling wrappers, and chopping meat fillings are also repetitive labor. These actions are also common causes of edema, so try not to do them.

Also, female patients like to carry backpacks when they go out, but they must not carry it on the affected side, that is, the arm on the side where the surgery was performed. It is generally recommended that patients carry a backpack.

Many patients also ask if they can play badminton. The best advice is not to play badminton. Try not to swing the racket like playing badminton. Also, don’t do the hand-shaking action repeatedly. Some patients said that the hand-shaking action can promote peripheral circulation, so they repeated the hand-shaking action, but after doing it, their arms became swollen.

Figure 2 Original copyright image, no permission to reprint

Another point is that patients who have undergone breast cancer surgery should be careful not to overexert themselves when dancing square dance. Ordinary people may be able to dance for an hour without any problem, but for her, she may have to rest for a while after dancing for 20 minutes to avoid overexerting the operated side.

Also, do not perform any invasive procedures. For example, if you have a cold or fever and go to the hospital to have blood drawn, an injection or an infusion, you must be aware and try not to measure blood pressure, have acupuncture, or have blood drawn on the affected arm.