Breast Cancer–Related Lymphedema and Resistance Exercise: A Systematic Review

Abstract

Nelson, NL. Breast cancer-related lymphedema and resistance exercise: a systematic review. J Strength Cond Res 30(9): 2656-2665, 2016-Breast cancer-related lymphedema (BCRL) is characterized by the accumulation of fluid in the interstitial tissues in the arm, shoulder, neck, or torso and attributed to the damage of lymph nodes during breast cancer treatments involving radiation and axillary node dissection. Resistance exercise training (RET) has recently shown promise in the management of BCRL. The aims of this review were twofold: (a) To summarize the results of recent randomized controlled trials (RCTs) investigating the effect of resistance exercise in those with, or at risk for, BCRL. (b) To determine whether breast cancer survivors can perform RET at sufficient intensities to elicit gains in strength without causing BCRL flare-up or incidence. A search was performed on the electronic databases PubMed, MEDLINE, SPORT Discus, and Science Direct, up to July 10, 2015, using the following keywords: breast cancer-related lymphedema, strength training, resistance training, systematic review, and breast cancer. Manual searches of references were also conducted for additional relevant studies. A total of 6 RCTs, involving 805 breast cancer survivors, met the inclusion criteria and corresponded to the aims of this review. The methodological quality of included RCTs was good, with a mean score 6.8 on the 10-point PEDro scale. The results of this review indicate that breast cancer survivors can perform RET at high-enough intensities to elicit strength gains without triggering changes to lymphedema status. There is strong evidence indicating that RET produces significant gains in muscular strength without provoking BCRL.

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“…Therefore, the enhancement of the strength of the non-affected arm muscle strength can be used to speculate the improvement of muscle strength in the affected arm. In addition, there were no side effects that caused or aggravated lymphedema during the intervention, which also confirmed the conclusions of previous studies that resistance training does not cause or aggravate lymphedema in the affected side of BC survivors [39][40][41][42][43].…”

Does Exercise Have a Preventive Effect on Secondary Lymphedema in Breast Cancer Patients Following Local Treatment - A Systematic Review

“…Due to improved medical treatment options and early screening and detection, breast cancer survival rates have increased significantly in the last years, and more than 80% of patients can be cured [1]. Given the improved survival rates, dealing with treatment-associated side effects such as secondary lymphedema (SL) is a new challenge in cancer care [2]. SL is likely to occur after the surgical removal of lymph nodes or in conjunction with radiotherapy [3].…”

“…The ACSM guidelines indicate specific exercise programs oriented towards impairments associated with disease and medical treatment [8]. Strength exercise does not have any negative effects on an existing SL [9]; instead, it has beneficial effects such as improvement of strength [2] and lower exacerbation rates [10]. …”

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“…Nelson (2016) reviewed the effect of resistance training on lymphedema in breast cancer patients. In 6 randomized controlled trials, involving 805 breast cancer survivors, he concluded that breast cancer survivors can perform high-enough intensity resistance exercise training to increase strength muscle without any changes in lymphedema status (27). Keilani et al (2016) reviewed the influence of the resistance training on secondary lymphedema in breast cancer patients (28).…”