A comprehensive approach to rehabilitation interventions following breast cancer treatment - a systematic review of systematic reviews
Open accessAbstract
BACKGROUND: Breast cancer (BC) is the most common type of cancer in women worldwide. Post-treatment, patients suffer from side effects and have various rehabilitation needs, which means that individualization is fundamental for optimal rehabilitation. This systematic review (SR) of SRs aims to evaluate the current evidence on rehabilitation interventions in female patients following BC treatment. METHODS: Full-text SRs published in English from 2009 were searched in Embase, PubMed, Cinahl Complete, PsycINFO, AMED, SCOPUS, and Cochrane Library. INCLUSION CRITERIA: SRs of randomized or non-randomized controlled trials investigating the effects of rehabilitation interventions in women following BC treatment. All outcomes were considered. Methodological quality was evaluated using the AMSTAR 2 tool and interrater agreement was evaluated. Out of 1269 citations retrieved, 37 SRs were included. RESULTS: Five rehabilitation areas were identified: exercise and physical activity (PA), complementary and alternative medicine (CAM), yoga, lymphoedema treatment, and psychosocial interventions. The most solid evidence was found in exercise/PA and yoga. Exercise interventions improved outcomes such as shoulder mobility, lymphoedema, pain, fatigue and quality of life (QoL). Effects of yoga were shown on QoL, anxiety, depression, sleep disturbance, fatigue and gastrointestinal symptoms. The effect of CAM was shown on nausea, pain, fatigue, anger and anxiety but these results need to be interpreted with caution because of low methodological quality in included studies in the SRs. Among the lymphoedema treatments, positive effects were seen for resistance training on volume reduction and muscle strength and psychosocial interventions such as cognitive behavioural therapy had positive effects on QoL, anxiety, depression and mood disturbance. CONCLUSIONS: This SR of SRs show solid positive effects of exercise/PA and yoga for women following BC treatment, and provides extended knowledge of the effects of CAM, yoga, lymphoedema treatment and psychosocial interventions. It is evident that more than one intervention could have positive effects on a specific symptom and that the effects depend not only on intervention type but also on how and when the intervention is provided. The results can be used as a foundation for individualized rehabilitation and aid health care professionals in meeting patients' individual needs and preferences. TRIAL REGISTRATION: PROSPERO ( CRD42017060912 ).
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Somatic side effects of therapy (e.g., neurotoxicity, cardiotoxicity, lymphoedema, pain) and increased tumour-related stress or mental illnesses (e.g., anxiety, depression) play a central role in follow-up care.
“In addition to somatic side effects of the therapy, such as neurotoxicity and cardiotoxicity, lymphoedema or pain [6–8], increased tumour-related stress or mental illnesses such as anxiety and depression play a central role in follow-up care.”
From The BrEasT cancer afTER-CARE (BETTER-CARE) programme to improve breast cancer follow-up: design and feasibility study results of a cluster-randomised complex intervention trial (2024) · cites this paper as [8]
The Background identifies pain and lymphoedema as common consequences of breast cancer or its treatment, and also reports depression and psychological distress as rehabilitation concerns. The Results discuss anxiety and depression. Our copy does not substantiate the cited sentence’s specific examples of neurotoxicity or cardiotoxicity. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere is already good evidence for the effectiveness of individual interventions in meeting patients' needs in breast cancer follow-up.
“There is already good evidence for the effectiveness of individual interventions in meeting patients’ needs in breast cancer follow-up [8].”
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Cites
Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., et al. (2017) · BMJ · doi:10.1136/bmj.j4008 · Cited by 10,636 · see citing works
The Global Burden of Cancer 2013
Fitzmaurice, C., Dicker, D., Pain, A. W., Hamavid, H., Moradi‐Lakeh, M., MacIntyre, M. F., Allen, C., Hansen, G. M., Woodbrook, R., Wolfe, C. D. A., et al. (2015) · JAMA Oncology · doi:10.1001/jamaoncol.2015.0735 · Cited by 2,709 · see citing works
Methodology in conducting a systematic review of systematic reviews of healthcare interventions
Smith, V., Devane, D., Begley, C. M., & Clarke, M. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-15 · Cited by 1,227 · see citing works
Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life.
Bower, J. E., Ganz, P. A., Desmond, K. A., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2000) · Journal of Clinical Oncology · doi:10.1200/jco.2000.18.4.743 · Cited by 1,134 · see citing works
Prevalence of and Factors Associated With Persistent Pain Following Breast Cancer Surgery
Gärtner, R., Jensen, M.-B., Nielsen, J., Ewertz, M., Kroman, N., & Kehlet, H. (2009) · JAMA · doi:10.1001/jama.2009.1568 · Cited by 908 · see citing works
Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015) · Acta Oncologica · doi:10.3109/0284186x.2014.998275 · Cited by 535 · see citing works
Andersen, K. G., & Kehlet, H. (2011) · The Journal of Pain · doi:10.1016/j.jpain.2010.12.005 · Cited by 523 · see citing works
Duijts, S. F. A., Faber, M. M., Oldenburg, H. S. A., van Beurden, M., & Aaronson, N. K. (2011) · Psycho-Oncology · doi:10.1002/pon.1728 · Cited by 452 · see citing works
Cramer, H., Lauche, R., Klose, P., Lange, S., Langhorst, J., & Dobos, G. J. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010802.pub2 · Cited by 442 · see citing works
Lymphedema After Breast Cancer: Incidence, Risk Factors, and Effect on Upper Body Function
Hayes, S. C., Janda, M., Cornish, B., Battistutta, D., & Newman, B. M. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.14.4899 · Cited by 439 · see citing works
Maass, S. W. M. C., Roorda, C., Berendsen, A. J., Verhaak, P. F. M., & de Bock, G. H. (2015) · Maturitas · doi:10.1016/j.maturitas.2015.04.010 · Cited by 420 · see citing works
Meneses-Echavez, J. F., González‐Jiménez, E., & Ramírez‐Vélez, R. (2015) · BMC Cancer · doi:10.1186/s12885-015-1069-4 · Cited by 342 · see citing works
Exercise interventions for upper-limb dysfunction due to breast cancer treatment
McNeely, M. L., Campbell, K. L., Ospina, M. B., Rowe, B. H., Dabbs, K., Klassen, T. P., Mackey, J. R., & Courneya, K. S. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005211.pub2 · Cited by 329 · see citing works
Manual lymphatic drainage for lymphedema following breast cancer treatment
Ezzo, J., Manheimer, E. W., McNeely, M. L., Howell, D. M., Weiss, R. M., Johansson, K. I., Bao, T., Bily, L., Tuppo, C., Williams, A. F., et al. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003475.pub2 · Cited by 320 · see citing works
A prospective surveillance model for rehabilitation for women with breast cancer
Stout, N. L., Binkley, J. M., Schmitz, K. H., Andrews, K. S., Hayes, S. C., Campbell, K. L., McNeely, M. L., Soballe, P. W., Berger, A. M., Cheville, A. L., et al. (2012) · Cancer · doi:10.1002/cncr.27476 · Cited by 302 · see citing works
Juvet, L. K., Thune, I., Elvsaas, I. K. Ø., Fors, E. A., Lundgren, S., Bertheussen, G., Leivseth, G., & Oldervoll, L. M. (2017) · The Breast · doi:10.1016/j.breast.2017.04.003 · Cited by 288 · see citing works
Fucoidans Disrupt Adherence ofHelicobacter pylorito AGS CellsIn Vitro
Chua, E. G., Verbrugghe, P., Perkins, T. T., & Tay, C. Y. (2015) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2015/120981 · Cited by 276 · see citing works
Groef, A. D., Kampen, M. V. D., Dieltjens, E., Christiaens, M.-R., Neven, P., Geraerts, I., & Devoogdt, N. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.01.006 · Cited by 250 · see citing works
Yoga for breast cancer patients and survivors: a systematic review and meta-analysis
Cramer, H., Lange, S., Klose, P., Paul, A. E., & Dobos, G. (2012) · BMC Cancer · doi:10.1186/1471-2407-12-412 · Cited by 222 · see citing works
Bluethmann, S. M., Vernon, S. W., Gabriel, K. P., Murphy, C. C., & Bartholomew, L. K. (2015) · Breast Cancer Research and Treatment · doi:10.1007/s10549-014-3255-5 · Cited by 180 · see citing works
Huang, T., Tseng, S., Lin, C., Bai, C., Chen, C.-S., Hung, C., Wu, C., & Tam, K. (2013) · World Journal of Surgical Oncology · doi:10.1186/1477-7819-11-15 · Cited by 178 · see citing works
Return to work among breast cancer survivors: A literature review
Sun, Y., Shigaki, C. L., & Armer, J. M. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-016-3446-1 · Cited by 172 · see citing works
Cheema, B. S., Kilbreath, S. L., Fahey, P. P., Delaney, G. P., & Atlantis, E. (2014) · Breast Cancer Research and Treatment · doi:10.1007/s10549-014-3162-9 · Cited by 164 · see citing works
Psychological interventions for women with non-metastatic breast cancer
Jassim, G. A., Whitford, D. L., Hickey, A., & Carter, B. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008729.pub2 · Cited by 163 · see citing works
Halbach, S. M., Ernstmann, N., Kowalski, C., Pfaff, H., Pförtner, T., Wesselmann, S., & Enders, A. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.06.028 · Cited by 152 · see citing works
Fors, E. A., Bertheussen, G. F., Thune, I., Juvet, L. K., Elvsaas, I. Ø., Oldervoll, L. M., Anker, G. B., Falkmer, S., Lundgren, S., & Leivseth, G. (2010) · Psycho-Oncology · doi:10.1002/pon.1844 · Cited by 140 · see citing works
Zhu, G., Zhang, X., Wang, Y., Xiong, H., Zhao, Y., & Sun, F. (2016) · OncoTargets and Therapy · doi:10.2147/ott.s97864 · Cited by 133 · see citing works
Matthews, H., Grunfeld, E. A., & Turner, A. (2017) · Psycho-Oncology · doi:10.1002/pon.4199 · Cited by 117 · see citing works
Loh, S. Y., & Nadia, A. (2015) · Breast Cancer Targets and Therapy · doi:10.2147/bctt.s47012 · Cited by 116 · see citing works
Johannsen, M., Farver, I., Beck, N., & Zachariae, R. (2013) · Breast Cancer Research and Treatment · doi:10.1007/s10549-013-2503-4 · Cited by 113 · see citing works
Stuiver, M. M., ten Tusscher, M. R., Agasi-Idenburg, C. S., Lucas, C., Aaronson, N. K., & Bossuyt, P. M. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009765.pub2 · Cited by 111 · see citing works
Meta-analysis of the effects of exercise intervention on quality of life in breast cancer survivors
Zeng, Y., Huang, M., Cheng, A. S. K., Zhou, Y., & So, W. K. W. (2014) · Breast Cancer · doi:10.1007/s12282-014-0521-7 · Cited by 111 · see citing works
Chan, D. N. S., Lui, L. Y. Y., & So, W. K. W. (2010) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2010.05374.x · Cited by 108 · see citing works
Devoogdt, N., Kampen, M. V. D., Geraerts, I., Coremans, T., & Christiaens, M.-R. (2009) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2009.11.016 · Cited by 108 · see citing works
Matsuda, A., Yamaoka, K., Tango, T., Matsuda, T., & Nishimoto, H. (2014) · Quality of Life Research · doi:10.1007/s11136-013-0460-3 · Cited by 105 · see citing works
Huang, H.-P., He, M., Wang, H.-Y., & Zhou, M. (2016) · Breast Cancer · doi:10.1007/s12282-015-0604-0 · Cited by 105 · see citing works
Rogan, S., Taeymans, J., Luginbuehl, H., Aebi, M., Mahnig, S., & Gebruers, N. (2016) · Breast Cancer Research and Treatment · doi:10.1007/s10549-016-3919-4 · Cited by 101 · see citing works
Resistance exercise and secondary lymphedema in breast cancer survivors—a systematic review
Keilani, M., Hasenoehrl, T., Neubauer, M., & Crevenna, R. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-015-3068-z · Cited by 93 · see citing works
Pan, Y., Yang, K., Wang, Y., Zhang, L., & Liang, H. (2015) · Asia-Pacific Journal of Clinical Oncology · doi:10.1111/ajco.12329 · Cited by 83 · see citing works
Weight training is not harmful for women with breast cancer-related lymphoedema: a systematic review
Paramanandam, V. S., & Roberts, D. (2014) · Journal of physiotherapy · doi:10.1016/j.jphys.2014.07.001 · Cited by 83 · see citing works
Schmidt, M. E., Wiskemann, J., Schneeweiß, A., Potthoff, K., Ulrich, C. M., & Steindorf, K. (2017) · International Journal of Cancer · doi:10.1002/ijc.31138 · Cited by 80 · see citing works
Accuracy of the Danish version of the ‘distress thermometer’
Bidstrup, P. E., Mertz, B. G., Dalton, S. O., Deltour, I., Kroman, N. T., Kehlet, H., Rottmann, N., Gärtner, R., Mitchell, A. J., & Johansen, C. (2011) · Psycho-Oncology · doi:10.1002/pon.1917 · Cited by 79 · see citing works
Short, C. E., James, E. L., Stacey, F., & Plotnikoff, R. C. (2013) · Journal of Cancer Survivorship · doi:10.1007/s11764-013-0296-4 · Cited by 78 · see citing works
Chao, L.-F., Zhang, A. L., Liu, H., Cheng, M., Lam, H.-B., & Lo, S. K. (2009) · Breast Cancer Research and Treatment · doi:10.1007/s10549-009-0533-8 · Cited by 78 · see citing works
Omar, M. T. A., Shaheen, A. A. M., & Zafar, H. (2012) · Supportive Care in Cancer · doi:10.1007/s00520-012-1546-0 · Cited by 74 · see citing works
Tai chi for breast cancer patients: a systematic review
Lee, M. S., Choi, T., & Ernst, E. (2010) · Breast Cancer Research and Treatment · doi:10.1007/s10549-010-0741-2 · Cited by 72 · see citing works
Pan, Y. Q., Yang, K., Wang, Y. L., Zhang, L. P., & Liang, H. Q. (2013) · International Journal of Clinical Oncology · doi:10.1007/s10147-013-0635-5 · Cited by 72 · see citing works
Zhang, J. P., Yang, K., Tian, J., & Wang, C. (2012) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2011.0514 · Cited by 65 · see citing works
Xiao, F., Song, X., Chen, Q., Dai, Y., Xu, R., Qiu, C., & Guo, Q. (2017) · Clinical Breast Cancer · doi:10.1016/j.clbc.2016.11.003 · Cited by 65 · see citing works
Keesing, S., Rosenwax, L. K., & McNamara, B. A. (2018) · Women s Health · doi:10.1177/1745505718756381 · Cited by 58 · see citing works
Tai Chi Chuan Exercise for Patients with Breast Cancer: A Systematic Review and Meta-Analysis
Pan, Y., Yang, K., Shi, X., Liang, H., Zhang, F., & Lv, Q. (2015) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2015/535237 · Cited by 55 · see citing works
Manual lymphatic drainage for breast cancer-related lymphoedema
Shao, Y., & Zhong, D. (2016) · European Journal of Cancer Care · doi:10.1111/ecc.12517 · Cited by 48 · see citing works
Optimizing post-acute care in breast cancer survivors: a rehabilitation perspective
Amatya, B., Khan, F., & Galea, M. P. (2017) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s117362 · Cited by 48 · see citing works
Yan, J., Pan, L., Zhang, X., Sun, C.-X., & Cui, G. (2014) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2014.15.8.3715 · Cited by 46 · see citing works
Bränström, R., Petersson, L., Saboonchi, F., Wennman‐Larsen, A., & Alexanderson, K. A. E. (2015) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2015.04.008 · Cited by 45 · see citing works
Qualidade de vida e desempenho de atividades cotidianas após tratamento das neoplasias mamárias
Vendrúsculo-Fangel, L. M., Panobianco, M. S., Kebbe, L. M., de Almeida, A. M., & Gozzo, T. D. O. (2013) · Acta Paulista de Enfermagem · doi:10.1590/s0103-21002013000100015 · Cited by 44 · see citing works
Lee, P. L. T., Tam, K., Yeh, M., & Wu, W. (2016) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2016.06.003 · Cited by 37 · see citing works
Exercise Interventions for upper limb dysfunction due to breast cancer surgery
McNeely, M. L., Campbell, K. L., Courneya, K. S., Dabbs, K., Klassen, T. P., Mackey, J. R., Ospina, M. B., & Rowe, B. H. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005211 · Cited by 34 · see citing works
Current Knowledge of Pain After Breast Cancer Treatment: A Systematic Review
Cooney, M. A., Culleton-Quinn, E., & Stokes, E. (2011) · Pain Management Nursing · doi:10.1016/j.pmn.2010.09.002 · Cited by 29 · see citing works
Physical Activity and Quality of Life of Cancer Survivors: A Lack of Focus for Lifestyle Redesign
Lee, J. E., & Loh, S. Y. (2013) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2013.14.4.2551 · Cited by 12 · see citing works
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Research works printed but not linked: 1
- [12]Juvet LK, Elvsaas IKO, Leivseth G, Anker G, Bertheussen GF, Falkmer U, Fors EA, Lundgren S, Oldervoll LM, Thune I et al: In., edn. Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH). Copyright (c) 2009 by The Norwegian Institute of Public Health (NIPH). 2009. 29319956
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Sebri, V., Durosini, I., Triberti, S., & Pravettoni, G. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.611954 · Cited by 104 · see citing works
Schäfer, A., Wendel, J., Franke, I., Bauer, A., Baumeister, H., Bendig, E., Brucker, S. Y., Deutsch, T. M., Garatva, P., Haas, K., et al. (2024) · Trials · doi:10.1186/s13063-024-08614-8 · Cited by 3 · see citing works
“In addition to somatic side effects of the therapy, such as neurotoxicity and cardiotoxicity, lymphoedema or pain [6–8], increased tumour-related stress or mental illnesses such as anxiety and depression play a central role in follow-up care.”
- Authors
- Olsson Möller, U., Beck, I., Rydén, L., & Malmström, M.
- Affiliations
- Lund University (SE)
- Corresponding author
- Rydén, L.
- Venue
- BMC Cancer
- Published
- 2019-05-20
- Volume
- 19
- Issue
- 1
- Pages
- 472-472
- ISSN
- 1471-2407 (ISSN-L)
- PMC
- PMC6528312
- OpenAlex
- W2947113254
- Cited by
- 189
- References
- 61
- Citations by year
- 2026: 12 · 2025: 29 · 2024: 29 · 2023: 32 · 2022: 32 · 2021: 32 · 2020: 22 · 2019: 1
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Cancer (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Högskolan Kristianstad Publikationer (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Governmental funding of clinical research within the NHS (-)
- Percy Falks Stiftelse för Forskning Beträffande Prostata- och Bröstcancer (-)
- The Swedish Breast Cancer Association (-)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- breast cancer, post-treatment rehabilitation, exercise and physical activity, yoga, complementary and alternative medicine, lymphedema treatment, resistance training, psychosocial interventions, cognitive behavioral therapy, quality of life, fatigue, anxiety and depression, sleep disorders, personalized rehabilitation
- MeSH terms
- Systematic Reviews as Topic, Breast Neoplasms, Female, Humans, Lymphedema, Quality of Life, Yoga, Exercise, Treatment Outcome, Resistance Training
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