Multidisciplinary management of breast cancer

Physical activity/rehabilitation

To prevent weight gain, but also for its many beneficial effects on psychological and physical aspects, a regular physical activity is recommended for patients treated for breast cancer [10, 37, 50, 51]. Inactivity should be avoided and daily activities should be resumed as soon as possible after surgery and during adjuvant cancer treatment [10, 45, 51]. More specifically, concerning aerobic training, 20 to 60 min of exercise at a moderate intensity (50–75 % of the maximal heart rate) are recommended 3 to 5 times per week [10, 45, 51, 52]. For resistance training, it is recommended to follow a supervised program of approximately 2 to 3 sets of 8 to 15 repetitions with a very low load at baseline, 2 to 3 times a week. The resistance can be increased in small increments without any upper limit, but it is important to monitor the appearance of symptoms of the arm and/or shoulder such as a lymphedema and to reduce the resistance or stop the exercises according to the complications observed [10, 45, 52]. Finally, with regard to stretching, it is advisable to stretch the large muscle groups for 10 to 30 s 2 to 3 times per week [10, 45].

Many clinical trials and systematic reviews have evaluated the benefits of physical training in patients being treated for breast cancer. Although these studies differ according to timing of the intervention (during or after treatment), location (home or institution), duration, frequency and type of exercises performed and thus although no consensus is yet clear on these parameters, many benefits have been objectified. Thus, in view of the literature, physical activity/rehabilitation can have a positive impact on the quality of life of breast cancer patients [10, 37, 50, 53–65], on fatigue [10, 37, 50, 54, 56, 57, 60, 63, 66–68], on cardiopulmonary function (resting and/or maximal heart rate and maximal oxygen consumption) [10, 50, 53, 57, 58, 60, 61, 67–74], on weight and body composition (body weight, body mass index and/or percentage of body fat or lean mass) [10, 50, 57, 61, 66, 69, 71, 75–77] and on the psychological, emotional and physical well-being (such as anxiety, depression, body-image) [10, 37, 50, 54, 55, 57, 60, 61, 67, 72, 75].