•  manual lymphatic drainage (MLD);
  • breast cancer-related lymphoedema;
  • lymphoedema management;
  • lymphoedema therapy;
  • combined decongestive therapy (CDT);
  • massage

This paper describes a randomized controlled crossover study examining the effects of manual lymphatic drainage (MLD) in 31 women with breast cancer-related lymphoedema. MLD is a type of massage used in combination with skin care, support/compression therapy and exercise in the management of lymphoedema. A modified version of MLD, referred to as simple lymphatic drainage (SLD), is commonly taught as a self-help measure. There has been limited research into the efficacy of MLD and SLD. The study reported here explores the effects of MLD and SLD on a range of outcome measures. The findings demonstrate that MLD significantly reduces excess limb volume (difference, d=71, 95% CI=16–126, P=0.013) and reduced dermal thickness in the upper arm (d=0.15, 95% CI=0.12–0.29, P =0.03). Quality of life, in terms of emotional function (d=7.2, 95% CI=2.3–12.1, P=0.006), dyspnoea (d=−4.6, 95% CI=−9.1 to −0.15, P=0.04) and sleep disturbance (d =−9.2, 95% CI=−17.4 to −1.0, P=0.03), and a number of altered sensations, such as pain and heaviness, were also significantly improved by MLD. The study provides evidence to support the use of MLD in women with breast cancer-related lymphoedema. The limitations of the study are outlined and future areas for study are highlighted.