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The role of physical activity in lymphedema after breast cancer surgery – Dana-Farber Cancer Institute

Dana-Farber Cancer Institute/LinkedIn

Apr 14, 2025, 09:13

The role of physical activity in lymphedema after breast cancer surgery – Dana-Farber Cancer Institute

Dana-Farber Cancer Institute shared a post on LinkedIn:

“After her breast cancer surgery, Tia struggled with mobility in her left shoulder. It felt as though the joint was frozen, and she could feel some swelling in her chest. After several dead ends, she learned that this feeling may be caused by early-stage lymphedema.

This condition is a common side effect of breast cancer operations in which underarm lymph nodes are removed. Taking those nodes out of the equation results in buildup of lymph fluid – the resulting swelling is uncomfortable and may affect the shoulders, arms, and chest. It may even predispose someone to infection and influence their mobility.

Jennifer Ligibel, MD, a breast oncologist who specializes in exercise research, notes that there may be psychological effects associated with lymphedema as well. For people who have made it through breast cancer treatment, the swelling, and some of the typical interventions like compression sleeves, are a reminder or a mark of the disease they survived.

Tia wanted to explore every option available to prevent lymphedema, so she visited Nancy Campbell, MS, a clinical exercise physiologist at our Leonard P. Zakim Center for Integrative Therapies.

Had Tia sought care for this two decades ago, most physicians would have recommended moving as little as possible. Noting an onset of lymphedema after an inciting event like raking leaves or shoveling snow, these physicians believed that strenuous movement led to lymphedema.

“We used to tell people to never lift more than five pounds,” Ligibel says. “It was probably the worst advice you could give.”

She explains that this theory did not recognize the importance of regular exercise to keep muscles conditioned.

This changed in 2009 when a study led by University of Pittsburgh’s Kathryn Schmitz, PhD, MPH, compared a group of patients that underwent an exercise regimen to another that did not. It was found that a supervised weightlifting program could prevent and even reduce the problems associated with lymphedema, as it improves muscle tone and helps lymph fluid move appropriately. In the years since, several other studies have bolstered this conclusion. Exercise was found to also lower risk factors for lymphedema like obesity and inflammation.

We were quick to adjust our programs to reflect the change, introducing strength training and yoga programs specifically for lymphedema prevention in the Zakim Center.

“The training needs to be structured,” Ligibel warns. “Weight should be increased slowly, and every patient should speak with their physician before starting an exercise regimen.”

During a consultation, Campbell outlined a regimen for Tia that would avoid injury and bolster strength over time.