Dear OncoLink "Ask The Experts,"

If a person were treated for breast cancer four years ago andhad taken every precaution to avoid lymphedema, but recently had her blood pressure taken multiple times on the arm that was on the same side as the cancer, how much would that increase her risk for lymph edema, and when would it start showing up?

Does the American Cancer Society have something that a person could wear at all times, or at least when one is in surgery [and therefore under anesthesia], to remind people not to use the affected arm? If a person had cancer on both breasts, where are blood pressures taken and blood drawn and IVs started?

Lora Packel MS, PT, Coordinator of Cancer Therapy Services for the Hospital of the University of Pennsylvania, responds:

Great question! It is impossible to predict who will get lymphedema from repeated blood pressure measurements in an at-risk arm. The majority of people will not suffer any long-term issues. Remember that your risk is very small if you had a sentinel lymph node biopsy, where only a handful of lymph nodes are removed.

It is important to remind your practitioners to use the arm that didn't have any lymph node removal, when possible. However, there may be occasions where practitioners have little choice. One must weigh the risks of developing lymphedema with the importance of monitoring vital signs.

Finally, the National Lymphedema Network does sell bracelets to remind practitioners not to use a particular arm for vital signs, blood draws, or IV's. Their website is www.lymphnet.org. Women who receive bilateral mastectomies can get blood pressure taken in their legs, although many practitioners usually take the BP on the side with less extensive surgery.

To learn more about lymphedema and prevention, visit OncoLink's section on lymphedema and check out this article, Lymphedema Q&A with Kathryn H. Schmitz, PhD, MPH, Assistant Professor, Center for Clinical Epidemiology and Biostatistics


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