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Some breast cancer surgery patients develop chronic arm swelling as a consequence of having underarm lymph nodes removed. This swelling is called “lymphedema.” However, using current surgical techniques, the risk of this occurring is greatly reduced.

The arm swelling is caused by an accumulation of fluid that is unable to return to general circulation. In breast cancer surgery patients, removal of a large number of underarm lymph nodes (axillary node dissection) can disrupt the lymphatic channels and result in fluid accumulation in the arm.

Sentinel node biopsy procedures allow removal of many fewer lymph nodes than the standard lymph node dissections routinely performed in the past. Patients who undergo only a sentinel lymph node sampling very rarely develop lymphedema.

Those patients with axillary lymph nodes found to be involved by cancer, generally require that more lymph nodes are removed through a procedure known as axillary node dissection. There can be some risk for the development of lymphedema for these patients. Additional lymphedema risk factors include obesity, age and radiation to the lymph nodes.

In high-risk patients, lymphedema cannot always be avoided. Precautions that may help include the avoidance of infection or injury to the arm and avoidance of constriction of the arm (tight clothing, blood pressure cuffs, wearing a heavy purse, etc.).

The risks from IVs and blood draws occur only if there is injury from those procedures. Blood draws or IVs themselves generally do not cause lymphedema in the absence of some complication. Be sure to check with your physician for any additional precautions.

If lymphedema develops or seems to be developing, evaluation can be arranged with a lymphedema specialist. An appropriate physical therapy program can minimize the degree of swelling and in some early cases, reverse the process.