my friend just had a bilateral mastectomy. She has heard that she can not have blood pressure taken in the arm anymore is this true.
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Q: can you take blood presure in arm after bialteral mastectomy.
Answers (6)
12/ 9/08 10:11pm
Wendy, people used to believe this, but studies have shown that women with double mastectomies, who get their blood pressure taken in either arm, aren't at any more risk for lymphedema than anyone else. So it's kind of an old wives' tale... Nevertheless, if she's apprehensive, she can ask to have her blood pressure taken in the femoral artery in her leg. Hope this helps- PJH
12/10/08 2:50pm
Wendy the factor in this is if she had any lymph nodes removed during her bi-lateral mastectomy. If nodes were taken from one side then all needle sticks and pressue cups should be avoided in that arm only. If they only removed the sentinal node for a biopsy then it will be okay - lymphedema is mainly a factor when all nodes have been removed, though there can still be minor problems when just one has been removed. If she had nodes removed from both sides, then for the sake of lymphedema it should be avoided and pressure taken in the leg. However in the event of an emergency pressure cups or needle sticks won't matter much when it's a matter of life or death. If such a case happens then likely her doctor will rx antibiotics should an infection occur.
Angi
1/18/10 11:15pm
This is not an old wives tale. It is very important to find out whether lymph nodes were removed during the mastectomy. If lymph nodes have been removed, then it is important to take from other arm, or the leg -- this is to prevent lymphedema in the arm.
1/19/10 7:20am
It's true, there actually is some controversy over this - whether you need to avoid blood pressure cuffs or not. Expert opinions differ. To be super-safe, if you've had lymph nodes removed under both arms, ask for blood pressure to be taken somewhere else. PJH
5/10/12 9:53am
Being super safe is fine but I have had so many patients worry about this while they smoke, weigh over 250 pounds and don't control their diabetes.
5/31/11 3:52pm
This depends on which doctor you ask. I had a bilateral in March, one doctor told me the same as they told your friend, and another said it was an old wives tale. I have had all axillary nodes removed in both arms and have been getting blood pressure on leg and foot draws for blood tests. I was hospitalized in an emergency situation and had IV's in my arm with no ill effects. I've also had IV chemo done using the arm. Although when they tried to do a blood pressure on my arm it caused excruciating pain and they had to stop and do it on my leg. I now have blood tests drawn from my arm since it is much less painful than the foot draw and no danger of blood clots in the legs. As long as it keeps working for me, that is the way I will do it. I'm hoping that after some time and I'm completely healed that I'll be able to have blood pressures on my arm also, as they are often inaccurate when they do them on my leg.
Our bodies are complicated and someone else in the same circumstances may have a completely different reaction than you do. Best answer is do what you think is right for you. You know your body and how it reacts better than anyone else, just listen to it and stop doing what you're doing if it causes problems.
5/31/11 5:17pm
The problem is, none of us knows how susceptible to lymphedema we are. for some women, it's "business as usual" with blood draws and blood pressure readings taken from the arm - and they're fine. For others, a blood draw or even repeated blood pressure cuffs can help instigate lymphedema. If you've had a mastectomy on one side, then it makes sense to simply have the work done on the other side; if you've had a bilateral, and need blood pressure readings and/or blood draws infrequently, then you might hazard using an arm. And, certainly if you're unable to use another part of your body for whatever reason, well, then you have to use your arms. But you're probably increasing your risk for lymphedema when you do... Tough choice, as with so many cancer decisions! PJH
5/31/11 6:52pm
Fortunately, from the lymphedema prevention point of view, most people who have bilateral mastectomies do not have lymph nodes removed on both sides so if using the leg or foot isn't working well for them, they can do blood pressure and needle sticks on the side that didn't have lymph nodes removed.
5/10/12 10:17am
The blood pressure warning is not rooted in lymphedema. Historically breast cancer was surgically treated with radical mastectomy. This was a terribly disfiguring procedure where the pectoral muscles were removed exposing the ribs and the axilla (armpit) was cleaned out. In the arm pit all of the tissue was removed to get the lymph nodes leaving the main arm artery traumatized. Sometimes the artery would scar down to a smaller diameter and this would lead to a lower blood presssure reading. Certainly all patients would also have severe lymphedema. There are very few surviving patients who had a true radical mastectomy now.
The modified radical mastectomy is a common procedure now. It rarely involves traumatiizing the artery. In fact we rarely even see it during the surgery. So a wrong blood pressure reading is no a real concern.
Lymphedema is still a post operative issue. Taning a blood pressure in an anrm with lymphedema is very inlikely to worsen it let alone cause it in an amr that does not have it.
Patients are being told the same information that was pertainent in the 1970's. Even some doctors are trained wrong. Staying up with surrent procedures and information is not easy but important.
5/10/12 11:25am
I'm sure it's not easy staying current with all the medical information and research out there, Joe - it's pretty mind-boggling. Thanks for your good feedback here; my opinion is, if taking blood pressure in your "off" arm isn't an issue, then why not? But if there's no choice, for whatever reason, than to take it in the arm close to surgery, then you're probably not putting yourself at very much risk, if any at all. Thanks again for connecting here - PJH
5/10/12 12:36pm
Part of my point is that there are soooo many mis-informed patients who are deathly afraid to get a BP taken on their surgical side when it is perfectly safe to do so. As in - they had just sentinal node biopsy and not axillary node disection. These patients are told by almost every nurse that treats them that someone who uses that arm for blood draw, IV and BP is committing mal-practice.
We only have a limited amount of veins. IV's can cause them to scar and disappear. Every month I run into a situation where a patient has no good usalble viens in the off arm and the patient is deathly afraid to let us touch the other.
Same goes with BP's. We do lots of operations on arms. Using the opposite arm for BP is typically better than using the leg (we have a fair amount of peripheral vascular diesease in our O.R. population).
We frequently operate on an arm on the side that had the breast cancer and the patient's never worry about it. If we try to start an IV they get very upset. If an IV is bad because of the possible side effects of infection and infiltration, how could surgery be OK to them? It is because of the dogma pounded into their brains by other health care providers who are just passing down bad information for generations.
5/10/12 4:52pm
Well, Joe, you're doing your part here to help women get over their unrealistic fears. Thanks - PJH
5/11/12 4:24pm
After mastectomy on right side, why are we not to draw blood on that side?
5/11/12 9:13pm
Donna, there's a bit of controversy about this perhaps being "old" information; read through the posts on this thread and you'll understand why. The reason is purportedly because you've had axillary lymph node surgery as well, and would be more prone to lymphedema; so it's best to avoid any undue stress on the arm, which would put pressure on the lymph system. Hope this helps - PJH
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Peripheral vascular disease in the legs is much more common than in the arms. So a wrong (lower) BP is somewhat more likely in the leg than in the arm.