How Can I Prevent Shoulder Problems After Breast Cancer

Physical Therapy to prevent shoulder problems after breast cancer surgery

Upper extremity problems are common after breast cancer treatment. Treatment can involve surgery to the breast and axilla, with or without radiotherapy, hormone and chemotherapy treatment. All of these treatments can affect the upper limb’s muscles, nerves, and lymphatic system. Prevention strategies are important to implement to assist in the recovery process returning to usual activity after treatment. 

A study recruited 392 women 18 and older with a high risk of developing shoulder issues after breast cancer treatment to explore the effectiveness of a structured exercise program related to upper limb function. Those randomized to the exercise intervention group were led in a structured program by a physical therapist that included strengthening, physical activity, and behavioral change strategies.

It was found that an early, structured exercise program not only improved pain and quality of life 1 year after breast cancer surgery, but it also improved upper limb function. The structured exercise program started the first postoperative week after surgery, was safe, and no serious adverse events were reported. Exercise also did not increase the risk of lymphedema. 

In conclusion, early physical therapy referral and prevention strategies for women at an increased risk of developing musculoskeletal problems after breast cancer surgery improves pain, quality of life, and upper extremity function with daily activities. 


Bruce J, Mazuquin B, Mistry P, et al. Exercise to prevent shoulder problems after breast cancer surgery: the PROSPER RCT. Health Technol Assess. 2022;26(15):1-124. doi:10.3310/JKNZ2003

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