Manual lymphatic drainage (or lymphatic drainage massage) is one of the primary treatments for lymphedema or swelling of the breast and chest. For those who have gone through lymph node removal from breast cancer surgery or have had radiation, they may have increased swelling in the breast and chest region.

Hi, my name is Kelly, and I’m a certified lymphedema therapist and physical therapist. I’ve worked with hundreds of lymphedema patients who are recovering from breast cancer treatment and have swelling in their breast and chest areas.

Below, I’m breaking down a step-by-step drainage routine for the breast and chest, the same sequence I walk patients through in my clinic.

What Is Breast and Chest Lymphedema?

Unfortunately, a common side effect of breast cancer treatment is increased swelling or, in some cases, lymphedema. Lymphedema is a condition that is caused by the buildup of lymph fluid in the body, usually as a result of a damaged lymphatic system. The increased lymph fluid can cause swelling, discomfort, and sometimes pain.

Breast cancer surgery, such as lymph node removal or sentinel node biopsy, can disrupt the natural flow of your lymph. Radiation therapy can cause scarring and inflammation in the lymphatic vessels, further impacting the lymph system and lymph drainage.

It’s important to know that not all people who undergo cancer treatment will get lymphedema. And for those that do, it is absolutely possible to reduce symptoms and improve your quality of life with the help of a lymphedema specialist and by adding simple things such as exercises for lymphedema, lymphatic drainage massage, and compression therapy into your lymphedema self-care routine.

What is Manual Lymphatic Drainage Massage

Manual lymphatic drainage massage is a type of massage used to gently guide lymph through the body and toward the lymphatic nodes (axillary nodes). It is often used by physical therapists as part of a lymphedema management plan. It uses very light pressure because the lymphatic vessels sit just beneath the skin, deep pressure isn’t needed and can actually be counterproductive.

In my practice, I use MLD as part of a broader lymphedema management plan. It can help reduce swelling, support immune function, and improve overall circulation in the affected area.

Lymphatic Drainage Routine for the Breast and Chest

You can follow along with this breast lymphatic drainage massage routine to promote lymph drainage and reduce swelling and congestion.

Watch the YouTube video 👇

Lymphatic massage details:

• This routine can be done sitting or standing
• 10 minutes needed for the routine
• Looking for a printable to follow along with? Shop my guide.
• No Equipment Needed

Before you begin

If you are currently experiencing any symptoms or pain, always check in with your doctor for clearance and safety.

This lymphatic drainage massage routine is safe to be done daily. It is recommended to do this routine directly on the skin.

As you move through the sequence, focus on using gentle pressure. The lymphatic system is just beneath the skin, so pressing hard during your massage is unnecessary.

Step-by-Step Lymphatic Drainage Massage Sequence

1. Begin with deep breathing

• Begin in a comfortable position.
• Place your hands gently on your belly.
• Take a deep breath through your nose, feeling your abdomen expand into your hands.
• Exhale slowly through your mouth.
• Repeat this deep breathing exercise three to four times.

Deep breathing creates movement in the large lymphatic vessels in your chest and trunk — it’s a simple but important first step.

2. Stimulate the collarbone lymph nodes

• Using your full hand on your skin, gently perform circular motions just below your collarbone on both sides.
• Do eight to ten circles on each side.

All of the fluid in your upper body moves through this area before returning to your heart, so clearing this space first gives the fluid somewhere to go.

3. Work around the ears

• Split your fingers to place them comfortably around your ears.
• Focus on the area just below and in front of the ears.
• Perform eight to ten gentle circular motions on each side.

4. Stimulate the lymph nodes in the armpit

• Place your hand directly into your armpit.
• Using light pressure, make eight to ten circular motions in either direction.
• Repeat on the other side.

This step activates the lymph nodes that all the fluid from your breast and chest drains toward. It’s one of the most important steps in this routine.

5. Stimulate the lymph nodes in the groin

• Place your hands where the sitting crease is, directly on the skin if able.
• Complete 8-10 circles in either direction.

It’s important to note that newer research shows most of the fluid stays in the the upper body, but because this step only takes a few seconds, it can still be beneficial, especially if one has fluid into the trunk and abdomen.

6. Move fluid down the side body

Next, you are going to work on the side of the body that you notice more swelling. This part may not be needed for many individuals who don’t have significant swelling, but if you have the time, I suggest adding a few strokes in.

• Use your whole hand to move excess fluid down the side of the body towards the groin.
• Complete 8-10 strokes here.

Divide Your Upper Body into Three Sections

Now you are going to think about dividing your upper body into three distinct sections: upper, middle, and lower chest regions.

7. Move fluid in the upper chest region

You are going to think about moving excess fluid away from the swollen side and toward the non-swollen side of the trunk. If you are someone who has swelling on both sides, you may just want to focus on one side for now, and that is okay!

• Using your whole hand, do 5-10 side strokes across the upper chest from one armpit towards the other.
• You should be using a nice light pressure, and directly on the skin if possible.

8. Move fluid in the middle chest region

• Begin in the middle of the chest or breast area and work across the midline toward the opposite armpit.

Feel free to spend more time as needed if you have additional fluid in the middle chest. You can also work above or below the breast area to guide fluid toward the armpit lymph nodes.

9. Move fluid from the outer breast

Now the focus will be on guiding the fluid from the outer part of the breast toward the same side. This reduces the amount of tissue that the fluid needs to move through, and is the natural direction that fluid likes to move toward within the lymphatic system.

• Using your whole hand, guide the fluid from the outer chest wall toward the armpit on the same side.
• Spend more time in an area that is troublesome and has more fluid.
• If you are someone who has severe fluid retention and swelling, you can then start to move the fluid down the side of the body toward the groin.

10. Move fluid around the armpit area

Something exciting that we are learning from new research is that a lot of the fluid goes toward the armpit, even if someone has had lymph nodes removed. This is why it’s so beneficial for the lymphatic health of those who have lymph nodes removed to continue working the area around the armpit, stimulating that area, and helping clear out fluid and congestion.

• Using your whole hand, complete 8-10 circles around the armpit area.

11. Finishing the routine

At this time, you can go back and focus on any troublesome areas of swelling that may require more manual lymph drainage.

I like to finish this lymphatic drainage massage routine by gently stimulating the main lymph nodes in the armpits, groin, and clavicle areas, just as we started.

Then place your hands on your belly and take a few big, deep breaths in and out.

Managing Lymphedema After Breast Cancer

If you’re noticing increased swelling, pain, or heaviness in your breast, chest, or arm, reach out to your doctor or a certified lymphedema therapist. A lymphedema specialist can help you create a personalized plan and make sure you’re using the right techniques for your specific situation.

Lymphedema is a chronic condition, but it is manageable and with the right support, most people are able to get back to doing the things they love.

If you are looking for more guidance on specific exercises and rehabilitation tools, make sure to check out my online self-paced program, Breast Cancer Rehab.

Improve Your Lymphatic Health in Just Minutes a Day – Get Started with Our Guide!

There are steps you can take to support your lymphatic health after breast cancer. By incorporating lymphatic drainage massage and other lymphedema exercises into your routine, you’ll not only reduce swelling but also support your immune health and improve circulation. The best part? It only takes minutes a day to see real benefits. Check out our shop for all downloadable guides.

Frequently Asked Questions

What does breast lymphedema look like?

Breast lymphedema often presents as increased swelling in the breasts, chest, or armpit areas. Someone may also feel heaviness, pain, or be more fatigued. If you suspect you may have breast lymphedema, you should reach out to your local healthcare professional immediately.

Where do breast lymph nodes drain?

Most of the lymph fluid from the breast drains toward the lymph nodes in the armpit, also called the axillary lymph nodes. These act as the main filtering station for fluid from the breast and chest before it eventually returns to the heart and back into circulation.

This is why the armpit is such an important focus during any lymphatic drainage routine.

Is it bad to do lymphatic drainage every day?

No, it is not necessarily bad for someone to do lymphatic drainage every day, and for many, it can be helpful as long as they don’t have underlying health conditions and have been cleared by their doctor to do so. Daily lymphatic drainage can have many benefits, which include reduced swelling, removal of toxins from the body, and improved immune system function.

What are the benefits of lymphatic drainage to the breast?

Lymphatic drainage to the breast (often referred to as manual lymphatic drainage) can have many benefits for those who are recovering from breast cancer surgery or treatment, such as radiation. MLD can improve breast health by supporting fluid circulation, reducing swelling, and removing toxins.