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Objective To determine the effectiveness of early physiotherapy in reducing the risk of secondary lymphoedema after surgery for breast cancer.

Design Randomised, single blinded, clinical trial.

Setting University hospital in Alcalá de Henares, Madrid, Spain.

Participants 120 women who had breast surgery involving dissection of axillary lymph nodes between May 2005 and June 2007.

Intervention The early physiotherapy group was treated by a physiotherapist with a physiotherapy programme including manual lymph drainage, massage of scar tissue, and progressive active and action assisted shoulder exercises. This group also received an educational strategy. The control group received the educational strategy only.

Main outcome measure Incidence of clinically significant secondary lymphoedema (>2 cm increase in arm circumference measured at two adjacent points compared with the non-affected arm …