Activities traditionally associated with increasing the risk of lymphedema do not appear to pose a threat. However, body mass index (BMI) greater than or equal to 25 lb/in2, full axillary lymph node dissection (ALND), regional lymph node radiation (RLNR), and cellulitis are significantly associated with the development of lymphedema.
Impact of Ipsilateral Blood Draws, Injections, Blood Pressure Measurements, and Air Travel on the Risk of Lymphedema for Patients Treated for Breast Cancer
Authors: Ferguson CM, Swaroop MN, Horick N, et al.
Source: J Clin Oncol, published online December 7, 2015.
There is widespread belief that breast cancer patients who have undergone ALND (full or sentinel) should avoid certain activities that are presumed to increase lymphedema risk. Many care providers advise against blood draws, injections, and blood pressure checks in the ipsilateral (operated side) arm. It is also commonly recommended that patients take specific precautions against trauma and wear compression garments on the affected side during air travel.
This group examined the outcomes of lymphedema in 632 female patients who received full or sentinel ALND as part of their breast cancer treatment. During follow-up office visits each participant was questioned about the number of times she had injections, blood pressure checks, or blood draws on the ipsilateral side. She was also asked about episodes of cellulitis and air travel. Arm girth was measured preoperatively and at regular postoperative intervals. Patient age, BMI, and tumor and treatment details were recorded. The median length of follow-up was 2 years.
Results showed no associations between ipsilateral blood pressure checks, injections, blood draws, air travel, or trauma and lymphedema. However, risk of lymphedema was increased in women with BMIs of 25 lb/in2 or greater, women who had had a full ALND, women who had received RLNR, and in women who had developed cellulitis.