Cheema, B., Gaul, C.A., Lane, K., & Fiatarone Singh, M.A. (2008). Progressive resistance training in breast cancer: A systematic review of clinical trials. Breast Cancer Research and Treatment, 109(1), 9–26.

To systematically review studies that have prescribed progressive resistance training (PRT) in breast cancer

Databases searched were PubMed, Medline, CINAHL, SportDiscus, Embase, and Web of Science. Search keywords were breast cancer, oncology, malignancy, neoplasm, tumor, mastectomy, lumpectomy, radiotherapy, chemotherapy, and exercise training, training, physical activity, rehabilitation, resistance training, aerobic training, strength training, lifestyle, muscle, endurance, and strength. Studies were included if they

• Had a patient population of adults aged 18 years or older diagnosed and surgically treated for malignancy of the breast
• Prescribed PRT in isolation or in combination with other exercise modalities (e.g., aerobic training) after breast cancer surgery, adjuvant therapies (i.e., radiotherapy or chemotherapy), or any other time after breast cancer treatment
• Evaluated outcomes potentially responsive to chronic PRT, including a broad spectrum of physiological, functional, and psychological outcome measures.

Studies were excluded if they investigated the effects of single, acute bouts of PRT, prescribed movement exercises without loading against a resistance, or prescribed PRT before breast cancer treatment.
 

The total number of studies initially reviewed was 12. The Delphi List was used as the method of study evaluation.
 

• The number of studies included in the report was 10.
• The total sample size across studies was 538, with a range of less than 20 to 242.
• Patients were female and being treated for breast cancer stages 0–III.
• Some patients had lymphedema.
• Patient age ranged from 25–78 years.
• Most patients were post-menopausal.
• The majority of patients received intervention after chemotherapy or radiation.

The study included a broad spectrum of physiological (body compositions, including reduced sum of five skinfolds, reduced waist and hip circumferences, reduced percent body fat, and increased muscle mass) , functional (improved upper-body strength, increased upper-body muscular endurance, increased flexibility of the ipsilateral (surgical) and contralateral shoulder joint, and improvements of lower-body strength) and psychological (improved aspects of quality of life, depression, and mood) outcome measures. Lymphedema incidence secondary to exercise programs was tracked as an adverse event in six studies. There was no incidence or exacerbation of lymphedema or improvements in lymphedema attributed to the exercise regimens.

Women surgically treated for breast cancer can derive health-related and clinical benefits by performing PRT after breast cancer surgery. No exacerbation or improvement of objectively measured or subjectively reported lymphedema symptoms were reported.

PRT should be advocated among oncologists and in community care settings.