Role of exercise prehabilitation on surgical prognosis in people with breast cancer: A Systematic review and call for action

Abstract

Abstract Background Breast cancer (BC) is the most common cancer worldwide, with surgery being the main curative approach. However, postoperative complications (PC) are frequent and may compromise recovery. Identifying strategies to optimize surgical prognosis is clinically relevant. Objective To synthesize the effects of multimodal, exercise-based prehabilitation on PC, hospital length of stay (HLS), reoperations, and readmissions in patients with BC undergoing surgery. Methods A systematic search was conducted in PubMed and Web of Science. Eligible studies were randomized or non-randomized controlled trials including patients with BC, implementing prehabilitation with physical activity or exercise, and assessing PC, HLS, reoperations, and/or readmissions. Results Two studies fulfilled the inclusion criteria. No significant differences were observed between prehabilitation and control groups for PC, HLS, reoperations, or readmissions. Nonetheless, one study reported more favourable outcomes in PC and reoperations related to previous breast surgery in patients undergoing prehabilitation. Conclusions Exercise-based prehabilitation may reduce PC and unplanned reoperations associated with prior surgery in patients with BC, although no differences were found for HLS or readmissions compared with usual care. Given the limited number of trials, further research is required to determine the potential benefits of prehabilitation on surgical outcomes in BC.