Physical exercise and breast cancer-related lymphedema: an umbrella review, systematic review and meta-analysis

The present study aimed to summarize the current evidence on the impact of exercise in patients at risk or with breast cancer-related lymphedema (BCRL) through an umbrella review of existing meta-analysis and a systematic review and meta-analysis of randomized controlled trials (RCTs). A search was conducted in PubMed and Web of Science up to June 2025 to identify meta-analyses and RCTs that included exercise interventions in patients at risk or with BCRL. Three systematic reviews including 14 individual meta-analyses were included in the umbrella review. Two of these met the criteria of strong evidence, reporting beneficial effects of exercise on upper- and lower-body strength. A total of 46 RCTs were included in the systematic review, of which 11 could be meta-analyzed. Strong evidence was found for a beneficial effect of exercise on upper- and lower-body strength and upper-limb disability. Strong evidence supports the beneficial effects of exercise on upper- and lower-body strength and upper-limb disability in patients at risk or with BCRL.