Lymphedema after breast cancer surgery: Who's at higher risk?

After breast cancer surgery, some people are more prone to lymphedema -- a swelling of the arm on the operated side.
This is especially common in patients who had a large number of lymph nodes removed during surgery. Even if many lymph nodes were not removed, the risk of lymphedema increases when radiation therapy is used as follow-up treatment.

“The risk of lymphedema increases when a large number of lymph nodes are removed,” said Professor Woo Kyong-je of the Department of Plastic Surgery at Samsung Medical Center, speaking on the hospital's YouTube channel. “During breast cancer surgery, not just one or two lymph nodes are removed—many are. In some cases, more than 30 lymph nodes are removed. If only a small number remain, the risk of lymphedema naturally increases.”

“Even if many lymph nodes remain after surgery, their function may be impaired because radiation therapy can damage them,” Professor Woo added. “If you undergo radiation therapy after surgery, there is a high chance that edema will occur -- even if only a few lymph nodes were removed. In such cases, you shouldn't overuse your arm.”

The most important thing breast cancer surgery patients can do to prevent lymphedema is to recognize their individual risk.
“It’s crucial to be aware that ‘lymphedema may occur after breast cancer surgery,’” Professor Woo explained. “This awareness helps patients avoid activities that increase risk and engage in those that help prevent it.”

Patients who have undergone breast cancer surgery are inherently at risk for lymphedema and should avoid overexerting their arms.
“You should avoid activities that require significant arm strength, such as hanging from a bar or doing planks,” Woo advised. “Most importantly, don’t use your arms for extended periods without rest. For example, doing housework continuously for more than an hour should be avoided.”

In particular, sudden onset of arm lymphedema often occurs in patients who overuse their arms -- such as during housework or moving heavy items.
“It often worsens after activities like pickling or moving, so those should be avoided,” Woo said. “Stretching and frequent massage are also important. But above all, the key is to prevent lymphedema before it starts.”