Efficacy of Evidence-Based Exercise as a Treatment for Breast Cancer Related Lymphedema

Breast cancer related lymphedema (BCRL) of the upper extremity is a frequent sequela following axillary node dissection (AND). A recent meta-analysis by Gillespie et al. (2018), suggested a 21.4% incidence of chronic arm edema post breast cancer intervention. Gillespie et al. (2018) explained that because of a lack of diagnostic criteria for BCRL, incidence reports varied widely from less than 5% to over 50%. The purpose of this review was to determine the efficacy of exercise in the self-management of BCRL, including the types and frequency of exercise. Protocols from 24 articles on the self-management of BCRL, including exercise as a home program, were reviewed to establish best practice guidelines. There is strong evidence that a graded program that includes a resistive exercise element is safe and will not exacerbate lymphedema symptoms when supervised and progressive. The evidence on specific parameters regarding exercise selection, sequencing, and progression is less clear. A multifaceted client treatment approach to BCRL shows significant positive effects on physical and mental health outcomes. Results of the literature review call for more rigorous studies which define best practices for exercise selection and sequencing in patients with BCRL post AND. Our research may influence lymphedema practitioner practice standards when integrating aerobic and resistive exercise tailored to their clients’ need for ethical and feasible treatment of BCRL post AND