Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay. If you have a drain coming out of your incision, follow your doctor's instructions to empty and care for it. Take precautions to prevent infection and swelling in your arm.
You will probably be able to go back to work or your normal routine in 3 to 6 weeks. It will also depend on the type of work you do and any further treatment. You may be able to take showers (unless you have a drain in your incision) 24 to 48 hours after surgery.
Lymph nodes drain fluid from your arms and legs. If the surgeon removes the lymph nodes, fluid can build up and cause swelling in your arms or legs. This is called lymphoedema. Your doctor and nurses will tell you how you can reduce your chance of getting lymphoedema.
You're likely to feel sore and have some discomfort after your lymph node removal. There's a risk of complications such as infection and ongoing pain, too. You'll also have a long-term risk of lymphoedema– a build-up of lymph fluid. Your doctor or nurse will give you advice on how to manage these problems.
The pain is usually caused by bruising, stretching or damage to nerves during surgery or when scar tissue forms. It seems to affect more people who have had surgery to the upper outer part of the breast and the armpit. These areas are particularly vulnerable to nerve injury.
Physical activity encourages fluid to drain into the lymphatic system in the abdomen. Walking, swimming, yoga, pilates and Tai chi all might help to encourage the lymph to move. Pelvic floor exercises may also help.
It is estimated that as many as 30–50% of patients who undergo lymph node dissection go on to develop lymphedema2, 3. Lymphedema can even occur after less invasive procedures such as sentinel lymph node dissection thereby putting nearly all cancer survivors at risk for this dreaded complication4.
Compression bandages or garments, such as sleeves, gloves, stockings or tights, fitted over affected limbs act as a counterforce to muscles. This stimulates more effective lymph drainage. The combination of exercise and compression encourages the fluid to move out of the affected limb.
Protein is essential to keeping your body healthy and fully functional. When you do not eat enough protein, fluid can seep from your bloodstream into your tissues, making lymphedema worse. For this reason, you should work healthy protein from seeds, nuts, eggs, legumes, fish, poultry and tofu into your regular diet.
More extensive lymph node removal, being treated on the non-dominant side, receiving radiation therapy and lower physical activity levels at 6 months was associated with higher body weights post-breast cancer (group differences >3 kg; all p < 0.05).
A team including University of Georgia researchers has for the first time documented the regrowth of surgically removed pathways in the lymphatic system, a network of vessels designed to pump away inflammatory fluids and defend the body against infection.
The remaining lymph nodes will take over and drain this fluid, but this may take a few weeks to months to happen. The drains are usually removed by the home care nurse according to instructions from the surgeon such as when they drain less than 30 mL in a 24-hour period, or 7 to 10 days after surgery.
Lymph nodes play a key role in filtering out bacteria and other harmful substances while also exposing them to infection-fighting white blood cells and triggering an immune response. The more lymph nodes you have removed, the greater the disruption to your immune system.
You will have the drain for at least 7 days and up to 4 weeks. Your drain will come out when the drainage is less than 30 millilitres (just over 2 tablespoons) in 24 hours for 2 days in a row. A nurse can remove your drain. You may take pain medication 30 to 60 minutes before the drain is removed.
Some mild swelling after surgery is normal. This swelling may last for up to 6 weeks. It's often temporary and will gradually go away. You may also feel pain or other sensations such as twinges and tingling after your surgery.
People who do develop lymphedema do so within two to three years after their surgery, but it is important to note that the risk remains over a person's lifetime and increases with trauma or injury to a limb. In some cases, these symptoms develop before swelling is noticeable.
Because a nerve was damaged, this pain is often called “neuropathic” or nerve pain. This nerve pain can start shortly after surgery and can last for as long as a few years after surgery.
Avoid skin infections, burns, and injuries
Your body responds to infection, burn, or injury to the skin by sending extra fluid and white blood cells to the area. If lymph nodes and vessels are missing or damaged, it's harder for your body to move this extra fluid, which can trigger or worsen lymphedema.
Raising the affected limbs can help reduce swelling. Your doctor may recommend that you rest the affected arm on a pillow above the level of your heart or elevate your legs when you lie down.
Right after your surgery
This swelling may last for up to 6 weeks. It's often temporary and will gradually go away. You may also feel pain or other sensations such as twinges and tingling after your surgery. Follow these guidelines to help relieve the swelling after your surgery.
Removal of the lymph nodes enables doctors to determine if a cancer has begun to metastasize. A lymphadenectomy may also prevent further spread of abnormal cells.