As of last year, breast cancer was among one of the most prevalent cancers in women in the United States. There are more than 3.1 million women with a history of breast cancer in the United States, and this includes those currently being treated. In the past few decades there have been major advancements in treatment, surgery, and detection approaches that have significantly increased survival rates. However, with those advancements many of these treatments can still cause functional issues in regards to range of motion, daily activities, and cardiopulmonary fitness. With the advancing research in secondary treatments, certain exercise considerations have been established among those completing treatments and managing survivorship. (Statistical source: breastcancer.org)

Surgeries

Treatment for breast cancer most commonly includes some form of surgery. Surgeries can range from least invasive such as a lumpectomy, to most invasive such as a radical mastectomy. Most women, regardless of where they fall on the spectrum of treatment, will still experience side effects including skin tightness, range of motion issues, pain, and increased risk for lymphedema. (We will talk about lymphedema later in the section). Range of motion issues are related to the shoulder and it is recommended that you be assessed by a professional before starting a resistance exercise program if you’ve had surgery and or radiation to the chest and underarm area. A slow progression is recommended when beginning any new program and starting with range of motion exercises both with shoulder motions and reaching overhead is encouraged.  

Other surgeries include reconstruction and implants. These types of surgeries propose considerations with pushing motions such as the chest press, push ups etc. Caution should be taken with the intensity (percentage of weight) and incorporation of such movements into your routine if you have had reconstruction and/or implants as you may put yourself at risk for rupturing the implant. 

Cardiopulmonary

Women who undergo certain types of chemotherapy and hormone therapies experience pulmonary and cardiovascular damage both short term and long term. Some experience side effects as little as four weeks into treatment. These side effects can last and even worsen months, even years after treatment. Moderate intensity aerobic exercise has shown to mitigate the significant decreases in cardiovascular function seen in many breast cancer patients. The ability to attenuate these side effects goes a long way in decreasing the risk of morbidity in this population. Supervision or approval from a medical professional is advised if you are experiencing any cardiovascular issues or if you are unsure where you are at physically before beginning a new regiment. 

Lymphedema

One of the most common side effects seen in breast cancer patients is lymphedema. The removal of lymph nodes in conjunction with radiation treatment increases the overall risk of lymphedema among patients and survivors. In previous years, exercise was feared among patients as it was assumed to exacerbate lymphedema. However, exercise has recently been established as safe among overall breast cancer patients and furthermore patients with already diagnosed lymphedema. It has also been shown to even improve symptoms, as the muscle contractions of exercise can help increase blood flow and in turn help reduce swelling.

Compression sleeves may also be advised to help with the symptoms of lymphedema. Supervision from a doctor and/or a fitness professional in the field of exercise oncology is recommended if beginning a resistance exercise program. Dose-response is extremely important to monitor and record as you begin. Starting slow/low and progressing in small increments is most encouraged to see how your body responds to the demands of exercise.

Overall Risk/Recurrence Risk

Physical activity and exercise has shown to reduces risk of breast cancer in women as compared to a those who live sedentary lifestyle! With that being said, adopting an activity lifestyle can help reduce your risks of breast cancer.

Increased physical activity levels among survivors have also shown to impact the risk of recurrence as well. Physical activity is known to affect weight and body composition which is a known risk factor in both normal population and cancer survivors in regards to risk of cancer or recurrence. It is recommended that you adhere to normal guidelines for exercise (150 minutes of moderate-intensity aerobic exercise and 2-3 of moderate to vigorous intensity resistance training a week according to ACSM) to help reduce risk of recurrence among breast cancer survivors.

What Now?

If you’re interested in resuming or engaging in new activities or exercises consult with your treating oncologist, physician, radiation oncologist, cancer exercise trainer, or trainer with a background in clinical populations to help you navigate getting back into enjoyable movement!