Structured Exercise Programs Can Preserve Movement After Breast Cancer Surgery

A new Cochrane review finds that exercise programs help patients recover shoulder movement and minimize loss of arm or shoulder function after breast cancer surgery, according to a press release.

Many breast cancer survivors develop pain, shoulder stiffness and arm swelling after treatment. These problems often persist for years. Physicians usually prescribe arm and shoulder exercises after surgery to prevent pain and stiffness in those areas on the side of the cancer. However, the best type of exercise or how soon it should begin have been debated.

“There has been some concern that too much aggressive movement soon after surgery might cause pain, delay healing, and increase the risk of arm swelling,” Margaret McNeely, lead review author, assistant professor of physical therapy at the University of Alberta and clinical researcher at the Cross Cancer Institute, in Canada, stated in the release..

McNeely’s team examined 24 research studies comprising 2,132 women with a confirmed breast cancer diagnosis who had undergone surgery such as a radical mastectomy, modified radical mastectomy, or a local wide excision or lumpectomy. They all had the same surgery removing lymph nodes from the axilla to determine the extent of the cancer.

The review showed that starting exercise early after surgery — within the first to third day — might result in better shoulder movement in the early weeks following surgery.

“Starting exercise that soon after surgery may cause more wound drainage and require drains to remain in place longer than if exercise is delayed by about one week,” McNeely said.

Fourteen studies compared the effect of structured exercise to usual care, in which women received an exercise pamphlet or no exercise instruction at all.

Of these, structured programs including physical therapy regimens in the early postoperative period led to a significant improvement in shoulder range of motion over the short and long term.

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