Abstract: Objective To explore the effectiveness of manual lymph drainage （MLD） in the treatment of breast-cancer-related lymphedema. Methods From 2008 to 2012, 101 patients with unilateral arm lymphedema after mastectomy were enrolled and divided into three groups based on the circumferential difference （d） between lymphedematous and contralateral limbs prior to MLD：group A （d〈1-2 cm）, group B （5 cm≥d≥2 cm）, group C （d〉5 cm）. After 1 course （15 days） of complex decongestive therapy （CDT）：MLD＋low elastic bandage, changes of limb circumference and tissue edema were measured and the differences between edema and non-edema arms after treatment were compared to evaluate edema reduction. Subjective feelings of each patient were recorded. Tissue edema were measured with multiple-frequency bioelectrical impedance analysis. Results After CDT treatment, significant reduction in circumference of the edematous limbs （ P〈0.01） and edema fluid in tissue （P〈0.01） were observed. Comparison of the reduction of excess tissue edema and limb circumference among 3 groups showed： group C〉group B〉group A （P〈0.01）. All patients were satisfied with the treatment. Conclusion Complex decongestive therapy is effective in treating lymphedema and improving physical appearance of the limb. The patients with more initial circumferential difference get better results in MLD.

Key words: Lymphedema, Manual lymph drainage, Breast cancer