Health-oriented Physical Exercise And Rehabilitation In Breast Cancer-related Lymphedema: Safety, Functional Outcomes And Quality Of Life - A Narrative Review

Abstract

Background. Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer treatment that can limit upper-limb function, daily activity and quality of life. Former advice to avoid strenuous arm use has been challenged by exercise-oncology evidence.  Aim. This narrative review summarises evidence on exercise and rehabilitation in women with or at risk of BCRL, focusing on safety, function, surveillance and practical prescription.  Material and methods. PubMed/MEDLINE, PubMed Central, NCBI Bookshelf, open-access platforms and guideline sources were searched for free full-text publications from 2016 to 2026. The final synthesis included 31 trials, reviews, cohort studies, consensus statements and guidelines.  Results. Slowly progressive resistance training is safe for most clinically stable women with or at risk of BCRL. Aerobic exercise, combined programmes, early mobility, yoga, Pilates-based rehabilitation and aquatic exercise are generally safe when individualised and progressed gradually. Exercise may improve strength, shoulder function, symptoms, fatigue, confidence and quality of life, although optimal dose and compression use remain uncertain.  Conclusions. Physical activity should be integrated into BCRL pathways with education, skin care, weight-management support, indicated compression and specialist referral for unstable cases. Exercise should be treated as a core component of survivorship care rather than as a risk to be avoided.