Understanding and Managing Breast Swelling
After Breast Cancer Treatment
by Berfin Mahmut, PT, DPT, CLT-LANA, OnCS
Breast swelling is a common experience for many breast cancer survivors, though it isn’t always talked about openly. It happens when fluid builds up in the breast and is most often related to treatments such as lymph node removal and radiation therapy, especially when the remaining lymph nodes are included in the radiation field.
If you have swelling in your breast you first may feel heaviness, puffiness in your breast. Your bra may also fit tighter on the affected breast compared to the other side. Swelling is often temporary and can occur during or in the weeks following radiation treatment. In some cases, if the swelling continues over time, it may be a sign of longer-term swelling, also known as breast lymphedema, which can be managed with the right care and support
You can also experience skin changes such as your breast feeling firmer, tender, and harder compared to your other breast. A visible sign of breast swelling is orange peel skin, also know as peau d’orange, where the skin takes a pitted and dimpled texture due to fluid accumulation.
Breast swelling can be successfully managed, and even reversed in early stages, with the right care and early intervention. Management includes manual lymphatic drainage, compression therapy, skin care, and exercise.
Manual lymphatic drainage
Manual lymphatic drainage is a gentle and specialized hands-on technique to help stimulate the remaining lymph nodes and reroute the fluid from the swollen areas to the areas with healthy lymph nodes. Manual lymphatic drainage requires skin-on-skin contact to be able to stretch the skin effectively in order to open the lymphatic channels for the fluid to be absorbed.
It also requires gentle pressure so that the fragile superficial lymphatic vessels are not damaged by deep pressure. Therefore, lymphatic drainage should never be painful. It is important to look for a medical lymphatic massage and a professional who is a certified lymphedema therapist with CLT credentials.
Manual lymphatic drainage is an effective technique in managing breast swelling. For the best results, it is should be combined with compression therapy, as this pairing works together to support fluid movement and reduce swelling more effectively.
Compression therapy
Compression garments for breast lymphedema come in the form of compression bras. They are medical grade compression, designed to reduce swelling by supporting the skin and the lymphatic system. They apply consistent, gentle compression and are worn daily, throughout the day from waking up until bedtime for best results.
It is very important for the compression garments to be the right fit, for them to be effective and comfortable. Therefore, speak with a CLT or a certified fitter so they can help you get a compression that fits you well.
Skin care
Keeping your skin healthy and well-protected plays an important role in managing lymphedema and reducing the risk of it developing. Simple daily habits—such as protecting your skin from sun exposure, avoiding cuts or insect bites, and caring for any signs of irritation or infection—can make a meaningful difference.
Regular moisturizing is also key. Applying a good-quality moisturizer once or twice a day helps maintain the skin’s natural barrier and supports overall skin health.
Exercise
Regular exercise and physical activity are important for lymphatic health. The lymphatic system lacks a central pump; therefore, it relies on movement in the body to help circulate fluid. When we exercise, our muscles contract and act as a pump to move the lymphatic fluid through the body.
If you are at risk for lymphedema or already experiencing it, the key is to begin with low intensity and shorter durations, then gradually build up over time. Starting slowly and progressing at a steady, comfortable pace helps your body adjust safely and effectively.
Early attention to breast swelling can make a meaningful difference, both in managing symptoms and in improving outcomes with the right care. If you are experiencing breast swelling or may be at risk, consider connecting with a Certified Lymphedema Therapist (CLT) for personalized guidance and support.
Berfin Mahmut is a Doctor of Physical Therapy, a certified lymphedema therapist, and a cancer exercise specialist who specializes in cancer rehabilitation at Mount Sinai in New York, NY.
