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Aim: To explore the effect of manual lymph drainage combined with physical exercise in preventing axillary web syndrome (AWS) after modified radical mastectomy. Background: In spite of the great progress achieved in mechanistic understanding, early detection, and adjuvant therapy, breast cancer remains the most common malignancy and the most common cause of death in women in China. AWS (aches in the upper limbs, tension at shoulder abduction, palpable cord structures, etc.) is a common early complication in breast cancer patients after axillary lymph node dissection, which reduces the quality of life of breast cancer survivors. Physical exercise is the traditional way to prevent postoperative complaints, whereas manual lymph drainage is relatively novel and is less frequently used, and its effects have not been determined. Design: A randomized controlled study. Methods: With approval from the Ethics Committee of Sun Yat-sen University (Guangzhou, China) and written informed consent obtained from all participating patients, four hundred women breast cancer patients were randomly divided into two groups (n=200/group) to receive either physical exercise alone(PE group) or self-administered manual lymph drainage as well as physical exercise(MLD group) after surgery. The presence of AWS was assessed at one, two and three months after surgery. Result: The occurrence rates in the two groups both gradually decreased over time. The numbers of patients with AWS in the PE and MLD groups at one month were 20 and 7(Pï¼ÂÂÃ‚Âœ0.05), respectively, at two months were 29 and 5(Pï¼ÂÂÃ‚Âœ0.01), respectively, and at three months were22 and 3(Pï¼ÂÂÃ‚Âœ0.01), respectively. Conclusions: MLD in combination with physical exercise is beneficial for preventing AWS and increasing comfort in breast cancer patients after modified radical mastectomy.