Skip to main content

Advertisement

Log in

Progressive resistance training in breast cancer: a systematic review of clinical trials

  • Review
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Background

Progressive resistance training (PRT) may be effective for targeting the sequelae of breast cancer and its treatment given the unique anabolic nature of this exercise modality. Therefore, our objectives were: (1) to systematically review studies that have prescribed PRT after breast cancer surgery, (2) to summarize the efficacy of PRT in this cohort, and (3) to delineate areas for future investigations.

Method

A systematic review using computerized databases was performed.

Results

The systematic review located 10 trials: Four uncontrolled trials, one controlled trial and five randomized controlled trials (RCTs). PRT was prescribed with aerobic training in 8/10 trials reviewed, and in isolation in 2/10 trials reviewed. Upper body PRT was prescribed in 7/10 trials, including 4/5 RCTs. No exacerbation of objectively measured or subjectively reported lymphedema symptoms was reported in any of these trials. Adverse events were rare, generally musculoskeletal in nature, and were managed effectively by conservative means. Overall, the studies we reviewed suggest that women surgically treated for breast cancer can derive health-related and clinical benefits by performing PRT after breast cancer surgery. Further research may be required to stimulate greater advocacy for PRT among oncologists, and in community care settings.

Conclusions

Robustly designed RCTs prescribing targeted PRT regimens throughout various phases of breast cancer treatment are warranted. RCTs with thorough, standardized reporting of interventions and adverse events are required to establish the efficacy of this intervention for the post-treatment management of breast cancer patients and survivors as a means to improve health status and quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Breast cancer: statistics on incidence, survival, and screening. Available at: http://www.imaginis.com/breasthealth/statistics.asp. Accessed May 21, 2007

  2. Servaes P, Verhagen S, Bleijenberg G (2002) Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study. Ann Oncol 13(4):589–598

    Article  PubMed  CAS  Google Scholar 

  3. Palesh O, Collie K, Batiuchok D, et al (2007) A longitudinal study of depression, pain, and stress as predictors of sleep disturbance among women with metastatic breast cancer. Biol Psychol 75(1):37–44

    Article  PubMed  Google Scholar 

  4. Jager G, Doller W, Roth RS (2006) Quality-of-life and body image impairments in patients with lymphedema. Lymphology 39(4):193–200

    PubMed  CAS  Google Scholar 

  5. Collado-Hidalgo A, Bower J, Ganz P, Cole S, Irwin M (2006) Inflammatory biomarkers for persistent fatigue in breast cancer survivors. Clin Cancer Res 12(9):2759–2766

    Article  PubMed  CAS  Google Scholar 

  6. Cianfrocca M, Flatters S, Bennett G et al (2006) Peripheral neuropathy in a woman with breast cancer. J Pain 7(1):2–10

    Article  PubMed  Google Scholar 

  7. Ott C, Twiss J, Waltman N, Gross G, Lindsey A (2006) Challenges of recruitment of breast cancer survivors to a randomized clinical trial for osteoporosis prevention. Cancer Nurs 29(1):21–31

    Article  PubMed  Google Scholar 

  8. Rooney M, Wald A (2007) Interventions for the management of weight and body composition changes in women with breast cancer. Clin J Oncol Nurs 11(1):41–52

    Article  PubMed  Google Scholar 

  9. Stubblefield M, Custodio C (2006) Upper-extremity pain disorders in breast cancer. Arch Phys Med Rehabil 87(3 (suppl 1)):S96–S99

    Article  PubMed  Google Scholar 

  10. Collins L, Nash R, Round T, Newman B (2004) Perceptions of upper-body problems during recovery from breast cancer treatment. Support Care Cancer 12(2):106–113

    Article  PubMed  Google Scholar 

  11. Satariano W, Ragland DR (1996) Upper-body strength and breast cancer: A comparison of the effects of age and disease. J Gerontol 51A(5):M215–219

    Google Scholar 

  12. Hack TF, Cohen L, Katz J, Robson LS, Goss P (1999) Physical and psychological morbidity after axillary lymph node dissection for breast cancer. J Clin Oncol 17(1):143–149

    PubMed  CAS  Google Scholar 

  13. McNeely M, Campbell K, Rowe B, Klassen T, Mackey J, Courneya K (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Can Med Assoc J 175(1):34–41

    Article  Google Scholar 

  14. Markes M, Brockow T, Resch K (2006) Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database of Syst Rev (online). October 19(4):CD005001

    Google Scholar 

  15. Jones L, Demark-Wahnefried W (2006) Diet, exercise, and complementary therapies after primary treatment for cancer. Lancet Oncol 7(12):1017–1026

    Article  PubMed  Google Scholar 

  16. American College of Sports Medicine (1998) Position stand: The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports and Exerc 30(6):975–991

    Article  Google Scholar 

  17. Cheema B, Abas H, Smith B, et al (in press) Progressive Exercise for Anabolism in Kidney Disease (PEAK): a randomized controlled trial of resistance training during hemodialysis. J Am Soc Nephrol 18(5):1594–1601

  18. Fiatarone Singh MA (2002) Exercise comes of age: Rationale and Recommendations for a geriatric exercise prescription. J Gerontol A Biol Sci Med Sci 57A(5):M262–282

    Google Scholar 

  19. Kent H (1996) Breast cancer survivors begin to challenge exercise taboos. Can Med Assoc J 155(7):969–971

    CAS  Google Scholar 

  20. McKenzie DC (1998) Abreast in a boat: A race against breast cancer. Can Med Assoc J 159(4):376–378

    CAS  Google Scholar 

  21. Harris SR, Niesen-Vertommen SL (2000) Challenging the myth of exercise-induced lymphedema following breast cancer: A series of case reports. J Surg Oncol 75(2):95–99

    Article  Google Scholar 

  22. Mitchell T, Yakiwchuk C, Griffin K, Gray R, Fitch M (2007) Survivor dragon boating: a vehicle to reclaim and enhance life after treatment for breast cancer. Health Care Women Int 28(2):122–140

    Article  PubMed  Google Scholar 

  23. Martyn-St James M, Carroll S (2006) High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporos Int 17(8):1225–1240

    Article  PubMed  CAS  Google Scholar 

  24. Verhagen A, de Vet H, de Bie R et al (1998) The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 51(12):1235–1241

    Article  PubMed  CAS  Google Scholar 

  25. Herbert R. Confidence Interval Calculator Version 4.1. (Updated 26/01/04). Available at: http://wwwpedrofhsusydeduau/tutorialhtml. Accessed 24 August 2006

  26. Becker L. Effect Size Calculators. (Revised 20/03/00). Available at: http://webuccsedu/lbecker/Psy590/escalc3htm. Accessed 25 February 2007

  27. Kolden G, Strauman T, Ward A et al (2002) A pilot study of group exercise training (GET) for women with primary breast cancer: Feasibility and health benefits. Psycho-Oncology 11(5):447–456

    Article  PubMed  Google Scholar 

  28. Turner J, Hayes S, Reul-Hirche H (2004) Improving the physical status and quality of life of women treated for breast cancer: A pilot study of a structured exercise program. J Surg Oncol 86(3):141–146

    Article  PubMed  Google Scholar 

  29. Lane K, Jespersen D, McKenzie D (2005) The effect of a whole body exercise programme and dragon boat training on arm volume and arm circumference in women treated for breast cancer. Eur J Cancer Care 14(4):353–358

    Article  CAS  Google Scholar 

  30. Cheema B, Gaul C (2006) Full-body exercise training improves fitness and quality of life in survivors of breast cancer. J Strength Cond Res 20(1):14–21

    Article  PubMed  Google Scholar 

  31. Hutnick N, Williams N, Kraemer W et al (2005) Exercise and lymphocyte activation following chemotherapy for breast cancer. Med Sci Sports Exerc 37(11):1827–1835

    Article  PubMed  Google Scholar 

  32. Nieman D, Cook V, Henson D et al (1995) Moderate exercise training and natural killer cell cytotoxic activity in breast cancer patients. Int J Sports Med 16(5):334–337

    Article  PubMed  CAS  Google Scholar 

  33. McKenzie DC, Kalda AL (2003) Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: A pilot study. J Clin Oncol 21(3):463–466

    Article  PubMed  Google Scholar 

  34. Herrero F, San Juan A, Fleck S et al (2006) Combined aerobic and resistance training in breast cancer survivors: A randomized, controlled pilot trial. Int J Sports Med 27(7):573–580

    Article  PubMed  CAS  Google Scholar 

  35. Ahmed R, Thomas W, Yee D, Schmitz K (2006) Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol 24(18):2765–2772

    Article  PubMed  Google Scholar 

  36. Ohira T, Schmitz K, Ahmed R, Yee D (2006) Effects of weight training on quality of life in recent breast cancer survivors. Cancer 106(9):2076–2083

    Article  PubMed  Google Scholar 

  37. Schmitz K, Ahmed R, Hannan P, Yee D (2005) Safety and efficacy of weight training in recent breast cancer survivors to alter body composition, insulin and insulin-like growth factor axis proteins. Cancer Epidemiol, Biomarkers Prev 14(7):1588–1595

    Article  Google Scholar 

  38. Courneya K, Segal R, Mackey J et al (2007) Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotheraphy: A multicenter randomized controlled trial. J Clin Oncol (in press)

  39. France L, Michie S, Barrett-Lee P, Brain K, Harper P, Gray J (2000) Male cancer: A qualitative study of male breast cancer. Breast 9(6):343–348

    Article  PubMed  CAS  Google Scholar 

  40. Beck AT, Ward CH, Mendelsen M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  41. Hamiton M. (1967) Development of a rating scale for primary depressive illness.Br J Soc Clin Psycho 6:278–296

    Google Scholar 

  42. Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: The PANAS scales.J Pers Soc Psychol 54(6):1063–1070

    Article  PubMed  CAS  Google Scholar 

  43. Howard KI, Vessey JT, Leuger R, Schank D (1992) The psychotherapeutic service delivery system. Psychother Res 2(3):164–180

    Google Scholar 

  44. Ganz PA, Schag CAC, Lee JJ, et al (1992) The CARES: A generic measure of health-related quality of life for patients with cancer. Qual Life Res 1(1):19–29

    Article  PubMed  CAS  Google Scholar 

  45. Cella DF, Tulsky DS, Gray G, et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure J Clin Oncol 11(3):570–579

    PubMed  CAS  Google Scholar 

  46. Brady MT, Cella DF, Mo F, et al ((1997) Reliability and validity of the Functional Assessment of Cancer Therapy-Breast (FACT-B) quality of life instrument J Clin Oncol 15(3):974–986

    PubMed  Google Scholar 

  47. World Health Organization Quality of Life Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 28(3):551–558

    Google Scholar 

  48. Ware JE, Snow KK, Kosinski MK et al (1993) SF–36 Health survey manual and interpretation guide. Nimrod Press, Boston, MA

    Google Scholar 

  49. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European organization for research and treatment of cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376

    Google Scholar 

  50. Schag CA, Ganz PA, Heinrich RL (1991). Cancer rehabilitation evaluation system—short form (CARES-SF). A cancer specific rehabilitation and quality of life instrument. Cancer 68(6):1406–1413

    Article  PubMed  CAS  Google Scholar 

  51. Rosenberg M (1965) Society and the adolescent self-image. Princeton University, Princeton, NJ

    Google Scholar 

  52. Moher D, Schulz K, Altman D (2001) The CONSORT statement: Revised recommendations for improving the quality of reports of parallel group randomised trials. Lancet 357(9263):1191–1194

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors sincerely appreciate the contributions of Dr. R. Hugh Morton in the preparation of this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bobby Cheema.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cheema, B., Gaul, C.A., Lane, K. et al. Progressive resistance training in breast cancer: a systematic review of clinical trials. Breast Cancer Res Treat 109, 9–26 (2008). https://doi.org/10.1007/s10549-007-9638-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-007-9638-0

Keywords

Navigation