IMPACT OF PHYSICAL ACTIVITY ON FUNCTIONAL RECOVERY AFTER BREAST CANCER SURGERY: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6559Keywords:
Breast Cancer, Physical Activity, Rehabilitation, Breast Surgery, Recovery, Lymphoedema, Quality of LifeAbstract
Background: Breast cancer is the most frequently diagnosed malignancy among women worldwide, with surgical intervention remaining the cornerstone of curative treatment. Despite improved survival rates, breast cancer surgery is associated with postoperative functional impairments - including restricted shoulder range of motion, pain, lymphoedema, and muscle weakness - that may compromise health-related quality of life.
Objective: To evaluate and synthesise the available evidence regarding the role of physical activity in improving functional recovery after breast cancer surgery, with attention to shoulder mobility, upper limb function, lymphoedema management, and quality of life.
Methods: A literature search of PubMed/MEDLINE, Scopus, and Web of Science was conducted for studies published between 2012 and 2026. Eligible publications included randomised clinical trials, observational studies, systematic reviews, and meta-analyses. Findings were synthesised qualitatively in accordance with the SANRA recommendations.
Results: Structured physical activity programmes are associated with improvements in shoulder mobility, upper limb function, and psychological well-being. Meta-analytic data confirm significant improvements in shoulder flexion (SMD 0.59), abduction (SMD 1.01), and upper limb function (SMD 0.87). Evidence indicates that appropriately prescribed exercise does not increase lymphoedema risk (RR 0.71, 95% CI 0.53–0.96) and may confer a protective effect. Some studies of very early unrestricted mobilisation reported short-term differences in wound outcomes, underscoring the importance of programme timing.
Conclusions: Physical activity constitutes a safe and effective component of postoperative rehabilitation following breast cancer surgery. Integration of individualised, evidence-informed exercise programmes into clinical pathways is strongly recommended.
References
Arnold M, Morgan E, Rumgay H, et al. Current and future burden of breast cancer: global statistics for 2020 and 2040. Breast. 2022;66:15–23. https://doi.org/10.1016/j.breast.2022.08.010
Lei S, Zheng R, Zhang S, et al. Global patterns of breast cancer incidence and mortality: a population-based cancer registry data analysis from 2000 to 2020. Cancer Commun (Lond). 2021;41(11):1183–1194. https://doi.org/10.1002/cac2.12207
Hu K, Ding P, Wu Y, et al. Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices. BMJ Open. 2019;9(10):e028461. https://doi.org/10.1136/bmjopen-2018-028461
Amato O, Guarneri V, Girardi F. Epidemiology trends and progress in breast cancer survival: earlier diagnosis, new therapeutics. Curr Opin Oncol. 2023;35(6):612–619. https://doi.org/10.1097/CCO.0000000000000992
Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3). Lancet. 2018;391(10125):1023–1075. https://doi.org/10.1016/S0140-6736(17)33326-3
Mokhtari-Hessari P, Montazeri A. Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health Qual Life Outcomes. 2020;18:338. https://doi.org/10.1186/s12955-020-01591-x
Myung Y, Choi Y, Kwon H, Heo CY. Quantitative analysis of shoulder function and strength after breast reconstruction. Arch Plast Surg. 2018;45(1):37–44. https://doi.org/10.5999/aps.2017.01004
Mohamed MH, Radwan RE, ElMeligie MM, et al. The impact of lymphedema severity on shoulder joint function and muscle activation patterns in breast cancer survivors. Support Care Cancer. 2025;33(1):37. https://doi.org/10.1007/s00520-024-09093-0
Koehler LA, Hunter DW, Blaes AH, Haddad TC. Function, shoulder motion, pain, and lymphedema in breast cancer with and without axillary web syndrome: an 18-month follow-up. Phys Ther. 2018;98(6):518–527. https://doi.org/10.1093/ptj/pzy010
Gala-Alarcón P, Prieto-Gómez V, Bailón-Cerezo J, et al. Changes in shoulder outcomes using ultrasonographic assessment of breast cancer survivors. Sci Rep. 2021;11:23016. https://doi.org/10.1038/s41598-021-02454-7
Rezende MS, Rossi DM, Ribeiro de Lima AM, et al. Shoulder and scapulothoracic impairments in women with breast cancer-related lymphedema. J Bodyw Mov Ther. 2024;37:177–182. https://doi.org/10.1016/j.jbmt.2023.11.012
Mafu TS, September AV, Shamley D. The potential role of angiogenesis in the development of shoulder pain, shoulder dysfunction, and lymphedema after breast cancer treatment. Cancer Manag Res. 2018;10:81–90. https://doi.org/10.2147/CMAR.S151387
Xu Q, Liu C, Jia S, et al. Effect of physical exercise on postoperative shoulder mobility and upper limb function in patients with breast cancer: a systematic review and meta-analysis. Gland Surg. 2024;13(8):1494–1510. https://doi.org/10.21037/gs-24-178
Anderson RT, Kimmick GG, McCoy TP, et al. A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial. J Cancer Surviv. 2012;6(2):172–181. https://doi.org/10.1007/s11764-011-0208-4
Redemski T, Hamilton DG, Schuler S, et al. Rehabilitation for women undergoing breast cancer surgery: a systematic review and meta-analysis. Clin Breast Cancer. 2022;22(7):650–665. https://doi.org/10.1016/j.clbc.2022.06.002
Klein I, Kalichman L, Chen N, Susmallian S. Effect of physical activity levels on oncological breast surgery recovery: a prospective cohort study. Sci Rep. 2021;11(1):10432. https://doi.org/10.1038/s41598-021-89882-9
Heiman J, Onerup A, Wessman C, et al. Recovery after breast cancer surgery following recommended pre and postoperative physical activity: (PhysSURG-B) randomized clinical trial. Br J Surg. 2021;108(1):32–39. https://doi.org/10.1093/bjs/znaa013
Plinsinga ML, Baker B, Spence RR, et al. A systematic review and meta-analysis evaluating the effect of exercise on the development of cancer-related lymphedema. JNCI Cancer Spectr. 2026;10(2):pkag013.
Mason C, Alfano CM, Wilder Smith A, et al. Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomarkers Prev. 2013;22(6):1153–1161. https://doi.org/10.1158/1055-9965.EPI-13-0141
Zukierski K, Jarych W, Michalak K, et al. The impact of physical activity on breast cancer prevention. Quality in Sport. 2025;41:60255. https://doi.org/10.12775/QS.2025.41.60255
Cemaga R, Hebda P, Czapliński M, et al. The role of physical activity in the prevention and management of various cancers. J Educ Health Sport. 2026;88:68346. https://doi.org/10.12775/JEHS.2026.88.68346
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Filip Bednarek, Olga Plinta, Alicja Hojda
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
