Lymphedema is often accepted as an inevitable and untreatable common consequence of breast cancer management. There has been little investigation of its pathophysiology, but reasonable hypotheses can be elaborated based on the known physiology of lymph production and removal. Both diagnosis and treatment remain largely empirical. A large clinical experience suggests that outcome is best with a multidisciplinary team approach that is based in an outpatient setting and combines gradient compression garments, sequential pneumatic pumps, and ancillary support services. Through this program, a majority of patients see greater than 50% reduction in their lymphedema.