Background and Aim:Balance disorder and lymphedema are side effects that may occur after breast cancer surgery.Pilates exercises and lymphatic massage have been recommended as complementary treatments to reduce these side effects. The aim of this study was to investigate the effectiveness of 12 sessions of Pilates exercise with and without lymphatic drainage massage on functional balance and lymphedema in patients with breast cancer aged 30 to 60 years. Methods:In this quasi-experimental pre-test and post-test research design study, 75 females with breast cancer selected by available sampling method and equally divided into three groups namely, Pilates, Massage-Pilates, and control. The Pilates group performed Pilates training and the Massage-Pilates group received exercises combined with lymphatic drainage massage for 12 sessions. During this period of time, the control group resumed their normal daily activities. The balance performance of all three groups at baseline and after intervention protocols was measured with the timed up-and-go test. Lymphedema was assessed by measuring the circumference of parts of the upper limb using a tape measure. Data were analyzed using analysis of covariance and the Bonferroni post hoc test (p<0.05). Results:Improvement in balance performance of breast cancer patients was observed in both the Pilates (p=0.001) and Massage-Pilates (p=0.001) groups, while no significant difference was observed in the control group. Comparison of the Pilates and Massage-Pilates groups did not show a significant difference (p=0.181). In addition, both interventions reduced lymphedema in the measured parts of the affected limb, except the wrist. Conclusion:According to the findings of this study, both Pilates training alone and combined with lymphatic drainage massage for 12 sessions were effective in improving balance function and reduces the severity of lymphedema in patients with breast cancer. It is recommended that these exercises be used as an effective method in the rehabilitation of patients after breast cancer treatment.