Can mastectomy cause lymphoedema?

Breast removal alone is not the only factor: lymph node surgery and radiotherapy to nearby drainage areas can also disrupt lymph flow. Swelling may appear soon after treatment or much later, and it can usually be managed more effectively when recognised early.

The lymphatic system returns tissue fluid to the bloodstream. When drainage pathways in the armpit or chest are reduced, protein-rich fluid can remain in the arm, hand, breast or chest wall and trigger ongoing swelling and tissue changes.

Early clues include heaviness, tightness, aching, puffiness, jewellery or sleeves feeling tighter, or reduced movement. Temporary postoperative swelling is also possible, so a trained clinician should assess a new change rather than relying on appearance alone.

Return gradually to arm activity after surgery and follow the physiotherapy exercises provided. Keep the skin clean and moisturised, treat small cuts promptly, use sun and heat protection, and wear gloves for tasks that might injure the hand. These steps reduce inflammation that can worsen swelling but cannot remove all risk.

Report persistent heaviness, tightness or swelling to the breast care team. A lymphoedema therapist can assess both sides and may recommend tailored exercise, compression, skin care and specialised massage. Compression garments should be measured and fitted rather than chosen solely by size.

Arrange an assessment if swelling is new, steadily increasing, affecting hand or shoulder movement, or accompanied by a firm area or new lump. Clinicians may need to exclude infection, a blood clot, treatment effects or cancer-related obstruction before attributing it to lymphoedema.

Seek same-day care for sudden redness, warmth, tenderness, rapidly expanding swelling, fever or feeling unwell because these can signal a skin infection. Sudden arm swelling with chest pain or shortness of breath requires emergency help.

Ask whether lymph nodes will be sampled or removed, when to begin shoulder exercises, and which swelling changes should be reported. After treatment, ask for referral to a lymphoedema service if symptoms persist and check whether planned blood tests, injections or blood-pressure measurements need any special approach.