Abstract
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.