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“Breast cancer is the most common cancer and the leading cause of cancer deaths among women,1 accounting for 23% of total cancer cases and 14% of cancer deaths. Early detection and recent advances in breast cancer treatment have improved the 5-year relative survival rate to above 80%.2 and 3 Despite this, cancer treatments cause many long-term functional impairments and considerably reduce the quality of life.4 Some of the post-treatment complications are: fatigue, weakness, loss of muscle extensibility, limited shoulder range of motion, upper body pain, pulmonary complications,

neuropathy, body composition and breast cancer-related lymphoedema (BCRL).5 and 6 BCRL is a chronic swelling of the arm, hand and associated trunk quadrant. It usually AZD6244 datasheet develops after damage R428 to the axillary lymph nodes due to breast cancer therapies. Surgical removal of lymph nodes, which is considered to be important for prognosis, causes permanent

damage to the lymphatic pathways.7 In addition, many patients are treated with external beam radiation and this may lead to constriction of the lymphatic vessels due to fibrosis, and delay the growth of newer lymphatic vessels after the lymph node excision.8 Thus, overall lymphatic drainage may be reduced significantly and lead to BCRL.7 This condition is associated with feelings of discomfort, pain, heaviness in the arm, disfigurement, psychosocial disturbance and elevated risk of infection, so BCRL is considered to

be the most feared complication of breast cancer.9 and 10 Published reports on the prevalence of BCRL range from 2 to 83%, although this wide variance is due in part to discrepancies in the definition, diagnostic ADP ribosylation factor threshold and measurement methods used.11 The onset of BCRL is unpredictable and can even occur many years after surgery.12, 13 and 14 It was believed that exercise could adversely affect the lymphoedema-prone arm in women with breast cancer, until the seminal work by McKenzie revealed no exacerbation or new cases of lymphoedema among women with breast cancer who participated in dragon boat racing.15 However, a prospective study by Johansson and colleagues16 reported an acute increase in arm volume within 24 hours following weight training. Additionally, a study by Lane and colleagues17 assessed the effect of exercise on BCRL by lymphoscintigraphy and revealed that the lymphoedematous hand had more similar lymphatic clearance to that of the controls during upper body exercises. However, exercises did not markedly increase the uptake of radiopharmaceuticals in the axilla and showed backflow. Hence, the authors concluded that exercise might increase the chance of BCRL. On the contrary, recent studies found no harmful effects of exercise on BCRL.