Upper limb lymphedema is the most important sequelae affecting the quality of life after breast cancer axillary lymph node dissection, with an incidence of about 20%. The incidence of lymphedema in the axillary nodes varies greatly from one patient to another, from six months after surgery to five years after surgery. The main reason for the occurrence of lymphedema in the upper extremities is the damage to the lymphatic vessels from the axilla to the inner part of the upper arm that sometimes occurs during the axillary lymph node dissection, and the infection that occurs when the surgical incision heals, which can further damage the residual lymphatic vessels and even cause obstruction of the subclavian or axillary veins, resulting in severe lymphatic edema. Although the scope of axillary lymph node dissection is getting smaller and fewer patients have severe symptoms, once lymphedema of the upper extremity occurs after surgery, the consequent limitation of shoulder joint movement, limb weakness, numbness, pain and swelling will bring a lot of inconvenience to the patients’ daily life. Measures to avoid or reduce effective edema 1. moderate activities: gradual exercise can help improve lymphatic circulation, such as stretching and abdominal whistling can change the pressure in the thorax and promote lymphatic reflux; moderate upper limb lifting exercises can stimulate the flow of lymphatic fluid through muscle contraction; 2. skin care, try to avoid injury and infection: pay attention to avoid insect bites and prevent skin injury; once the upper limb redness and swelling occur 3.Avoid high temperature of the upper limb: such as hot water immersion, sun exposure, sauna, etc.; 4.Avoid drug injection, blood sampling, immunization and blood pressure measurement of the affected upper limb for 5 years after surgery; 5.Avoid increased resistance to lymphatic reflux: do not wear tight underwear, necklaces and halter bras, too tight clothing can compress the supraclavicular region; 6.Avoid excessive blood flow in the upper limb: do less high-intensity upper limb exercise, avoid prolonged drooping of the affected upper limb and forceful shaking of the upper limb, etc. Note: Once the patient feels swelling or thickening of the affected upper limb, it may be a sign of early edema. What should I do if lymphedema occurs? 1.Conservative treatment Lymphology experts around the world tend to prefer conservative treatment for lymphedema. Comprehensive massage therapy is the most convenient method, and the step air pressure pump often used in hospitals to treat lymphedema is a common device therapy. Those with significantly thickened arms can also apply a moderate compression bandage. Taking some drugs to promote venous lymphatic reflux, such as strong mai zhi ling, diosmin, etc. may also have some effect. 2.Surgical treatment For cases where conservative medical treatment is not effective, severe upper limb edema, hard nodes around some edema are palpable and there is obvious pressure pain, surgical treatment can also be considered. Surgical treatment can remove excess water and tissue in lymph, relieve local lymphatic tissue pressure, promote lymphatic vessel function repair, and reduce the load on the lymphatic system. Although the clinical efficacy is still poor, and there are risks of recurrence of edema, difficult wound healing and secondary infection, related research has been intensively conducted. Currently, the reported surgical methods include subcutaneous buried drainage with silicone tubes (a type of fascial drainage technique), liposuction (theoretical basis: excessive lymphatic fluid and infectious factors contribute to excessive fibroblast proliferation, and excessive lymphatic fluid accumulates in the overgrown subcutaneous adipose tissue), veno-lymphatic anastomosis, lymphatic reconstruction with autologous vascularization, and veno-lymphatic anastomosis combined with autologous lymph node transplantation, etc.