Exercise-based interventions for postoperative rehabilitation in breast cancer patients: A systematic review and meta-analysis of randomized controlled trials

Background: This systematic review and meta-analysis aim to evaluate the effects of exercise interventions on pain, lymphoedema, shoulder joint range of motion (ROM), muscle strength, and quality of life in postoperative breast cancer patients, and to provide evidence-based recommendations for clinical practice. Methods: This systematic review and meta-analysis adhered to PRISMA guidelines and was registered on PROSPERO (CRD420251045309). A thorough search was performed in PubMed, Web of Science, Cochrane Library, and Embase for randomized controlled trials evaluating the effect of exercise on postoperative recovery in breast cancer patients. Data on pain, lymphoedema, ROM, muscle strength, and quality of life were extracted and analyzed using RevMan 5.4 software. The results were synthesized using weighted mean differences and odds ratios. Results: A total of 22 randomized controlled trials with 2305 patients were included in the meta-analysis. Exercise interventions significantly reduced postoperative pain (mean difference = −0.49, 95% confidence interval: −0.71 to −0.27, P < .0001) and improved muscle strength across various muscle groups. Exercise was also effective in reducing the incidence of lymphoedema (odds ratio = 0.34, 95% confidence interval: 0.19–0.61, P = .0003) and improving shoulder ROM, particularly in flexion, extension, abduction, and adduction. In terms of quality of life, exercise enhanced physical function, role function, and emotional well-being, and reduced fatigue and appetite loss. Conclusion: Exercise interventions are beneficial for improving pain management, lymphoedema control, upper limb function, muscle strength, and overall quality of life in postoperative breast cancer patients. These findings support the inclusion of exercise as a key component of postoperative rehabilitation. Future research should focus on optimizing exercise protocols and exploring long-term effects on breast cancer survivors.