The lymphatic system of the breast consists of lymph, lymphatic vessels, and lymph nodes. Lymphatic vessels drain or remove excess intercellular fluid from the breast, and lymph nodes drain this fluid and thus “clean” it of harmful substances, e.g. from bacteria and viruses. With breast cancer, in a certain percentage of cases, it is possible to spread through the lymphatic vessels and retain harmful cells in the lymph nodes, and it is necessary to remove them.

     When the lymph nodes are removed, it is possible to collect lymph fluid under the armpit. Usually, after surgery, a drain is placed to drain the excess lymph or it is punctured with a needle for the next few weeks.

     Lymphedema or arm swelling occurs after the removal of the armpit lymph nodes on the side of the operated breast due to the overload of the lymphatic system and the accumulation of lymph in the subcutaneous or fatty tissue.

     The patient usually notices a swelling or enlargement of the hand on the side of the operated breast which can spread to the whole arm. Pain, discomfort, and reduced mobility of the fingers, hand, or entire arm may occur. The skin is thickened and sometimes is red.

     Lymphedema or arm swelling can occur in any postoperative period, and is more common in patients who have also received radiotherapy.

     Immediately after the operation, the physiatrist together with the physiotherapist advises and does exercises with the patient in order to prevent the occurrence of lymphedema.

     Professional physiotherapist and specialist lymphotherapist Nenad Žujović explains what lymphedema is and what are the recommendations for its prevention.