Inclusion Criteria:

• Women, age >18 years
• Histologically confirmed invasive or non-invasive primary breast cancer scheduled for surgical excision
• Considered high risk of developing shoulder problems after surgery defined by one or more of the following:
  • planned axillary node clearance (ANC);
  • planned radiotherapy (RT);
  • existing shoulder problems (based upon PROSPER screening criteria);
  • obesity defined as BMI (greater than or equal to) >30;
  • any subsequent axillary surgery related to primary surgery, e.g. ANC conducted after sentinel lymph node biopsy (SLNB)
• Willing and able to comply with the protocol
• Written informed consent
• Any later decision (made within 6 weeks of surgery) to refer to RT

Note:

• Women who have had previous breast surgery (e.g. excision of benign tumour or breast cyst) are eligible for invitation;
• Women who have had previous contralateral (opposite side) mastectomy are eligible for invitation.

Exclusion Criteria

• Males
• Women having immediate reconstructive surgery
• Women having SLNB with or without breast surgery unless have other high risk criteria
• Women having bilateral breast surgery
• Evidence of known metastatic disease at time of recruitment