We recruited women who were over age 21, first time diagnosis of breast cancer (Stage I-III), and scheduled for surgical treatment, including lumpectomy or mastectomy, sentinel lymph node biopsy (SLNB) or axillary lymph node dissection ALND). Women with metastatic cancer (Stage IV), prior history of breast cancer and lymphedema, and bilateral breast cancer were excluded. Between April 2010 and June 2012, we prospectively enrolled 140 women and followed the participants for 12 months after surgery. All the participants received the The-Optimal-Lymph-Flow program.