Upper limb lymphedema is one of the common complications after breast cancer surgery, which seriously affects the quality of life of patients after surgery. However, it is still a difficult problem for massage therapists to worry about whether Chinese medicine massage can be applied. The pathological basis of ipsilateral upper limb edema after breast cancer surgery is the reduction, compression and narrowing of local small blood vessels and lymphatic vessels caused by surgery and radiotherapy, and the obstruction of blood and lymphatic fluid return. According to Chinese medicine, this is mainly due to the injury of blood vessels and nerves by gold blades during surgery, stagnation of blood vessels and veins, and poor circulation of qi and blood. Studies have shown that postoperative axillary vascular hemodynamics are significantly altered in breast cancer patients, and the peak values of maximum systolic flow velocity, end-diastolic flow velocity, and mean flow velocity of axillary veins are significantly lower in those with upper limb edema than in asymptomatic patients. Radionuclide scans also showed significantly lower lymph flow in the affected limb than in the healthy side. Although the postoperative pathological changes are the same, the tumor stage and the specific pathogenic factors or risk factors of edema vary from patient to patient. If we generalize postoperative edema as “meridian incompetence” without identifying it and rashly apply massage, it may lead to serious adverse consequences. According to the influence of postoperative physiological state changes, we can roughly divide the edema into two categories: physiological and pathological. Pathological mainly refers to postoperative edema of the upper limbs secondary to some other pathological factors such as tumor compression and venous thrombosis. For example, if breast cancer patients have supraclavicular lymph node metastasis or second cancer after surgery, the enlarged lymph node or tumor compresses the lymphatic vessels and aggravates the lymphatic circulation obstruction, leading to lymphedema in the upper limbs. This kind of edema is an absolute contraindication to massage, which may promote the metastasis of tumor; if venous thrombosis appears in the affected upper limb after surgery, which further affects the local blood circulation, it may aggravate or induce edema in the upper limb, and massage at this time may lead to the dislodgement of thrombus and cause serious adverse consequences, which is also not an indication for massage. Physiological refers to the surgical injury on the basis of treatment (such as radiotherapy), the affected limb overwork and obesity, advanced age and other physiological factors leading to edema, mainly due to lymphatic flow compensatory mechanism is not sound, and the emergence of factors that damage the compensatory mechanism or increase the lymphatic load and the onset. Although all such edema is caused by altered physiological status after surgery, two categories are distinguished according to the risk of postoperative recurrence. One category is surgically treatable patients with clinical stage I, clinical stage II, and some clinical stage IIIA (T3N1M0), who have relatively mild disease and limited lesions, which can be more completely resected by surgery, and postoperatively treated with local radiotherapy and/or systemic chemotherapy to achieve radical cure. Studies have shown that the 3-year postoperative survival rate of these patients is above 97%, and the 5-year survival rate is also up to 89.2%, and the 3-year and 5-year disease-free survival rates are also up to 91.3% and 86.1%, respectively. This category of patients with edema has a low risk of applying massage therapy. The other category is the one we should be particularly cautious with massage therapy. This category of edema patients are non-T3N1M0 clinical stage III patients who apply surgical treatment because of the clinical possibility of radical treatment. Their tumor infiltration is higher, lymphatic metastasis is more frequent, and the chance of cancer cell spread and metastasis is on the high side. Although a study including stage III patients concluded that the 3-year overall survival rate was 97.7%, the 5-year overall survival rate was 92.6%, and the 10-year overall survival rate was 82.1%. However, for these patients with edema, radiotherapy must be completed before massage, and recurrence and metastasis must be excluded, only then can the risk of massage be minimized. Modern research has proved that tui na can improve peripheral blood rheology and microcirculation, and also has a significant effect on the return of lymphatic fluid. As long as we strictly distinguish the nature of edema and grasp the indications, massage is feasible to treat lymphedema of the ipsilateral upper limb after breast cancer surgery. The basic principle is to promote blood and lymphatic reflux in the edematous upper limb through external pressure, which also reflects the feasibility of massage from one side. In recent years, foreign countries also actively advocate the whole body “massage” – lymphatic drainage method, which is considered to have positive significance in promoting lymphatic reflux to improve postoperative edema, but its specific operation is more cumbersome, unfavorable to the implementation and clinical promotion. At present, a few clinical workers in China are actively exploring the application of massage to prevent and treat postoperative edema. We have also summarized a set of “Tongluo anti-swelling” techniques according to the theory of Chinese medicine massage. The whole process takes about 15 minutes and is much easier than the lymphatic guide method. From 1995 to 2010, we treated more than 100 cases of postoperative upper limb edema of breast cancer, the longest treatment time was 2 years, and none of them had adverse reactions due to massage. We also noticed that massage was effective in improving patients’ self-symptoms with an effective rate of 100%, indicating that massage has a positive effect on improving patients’ quality of life. Chinese massage is a wonderful flower in the treasury of Chinese medicine, which will play a more positive role in controlling and improving the condition of lymphedema in the upper limbs of breast cancer patients after surgery and improving the quality of life of breast cancer patients.