A mastectomy, a surgery for breast cancer, involves removing breast tissue and sometimes nearby lymph nodes. After this procedure, post-operative care is important, especially for the arm on the side of the surgery, to prevent complications.
Understanding Lymphedema
Lymphedema is swelling that occurs when lymph fluid builds up in the body’s tissues. It often develops after cancer treatments like mastectomy, particularly when lymph nodes are removed or damaged. Axillary lymph nodes under the arm drain fluid from the upper arms, breast, and armpit. Removal or radiation to these nodes disrupts lymphatic drainage, leading to fluid accumulation and swelling.
Symptoms include swelling in the arm, hand, chest, or armpit. Patients may feel fullness, heaviness, tightness, aching, or discomfort. Clothing or jewelry may also feel tighter. It can appear soon after surgery or years later; it is a chronic condition managed with appropriate care.
Why Arm Pressure is Avoided
Applying pressure to the mastectomy-side arm, like from a blood pressure cuff, is discouraged due to lymphatic flow disruption. Compression can impede compromised lymphatic vessels, potentially triggering or worsening lymphedema. This is crucial if lymph nodes were removed, as lymphatic drainage is already reduced.
Repeated pressure increases the risk of fluid buildup, swelling, and discomfort. While some research suggests the risk from blood pressure measurements may be lower, clinical practice prioritizes minimizing strain on the lymphatic system. Healthcare providers advise avoiding blood pressure readings on the affected arm to prevent complications.
Safe Blood Pressure Monitoring
Blood pressure can be safely measured on the unaffected arm after a mastectomy. This is the recommended alternative. Always inform medical staff about your mastectomy history before any blood pressure measurements to ensure the correct arm is used.
For bilateral mastectomy or if the unaffected arm is unavailable, blood pressure can be taken at alternative sites. Options include the ankle, thigh, or wrist (though wrist cuff accuracy can vary). Consult a healthcare provider for the most appropriate alternative site.
General Arm Care Guidelines
Arm care is important after a mastectomy. Avoid injections, blood draws, and intravenous lines in the arm on the side of the surgery to minimize infection or lymphatic disruption. Skin protection from injury is also important.
Avoid tight clothing or restrictive jewelry on the affected arm, as it can constrict lymphatic flow. Limit heavy lifting or vigorous arm movements, especially during initial recovery. Gradually increase activity as advised by a healthcare professional. Report any new symptoms (redness, increased swelling, or pain) to a healthcare provider.