Pumping Iron May Aid Recovery After Breast Cancer Surgery
Strenuous weight training after breast cancer surgery is not only safe but also improves women’s strength, mobility, and balance, a study of one program finds.
Women who undergo surgery for breast cancer often hear that they should take it easy with exercise during recovery. But new research looking at intense strength training puts that advice into question.
The study, of nearly 200 women who’d undergone lumpectomy or mastectomy, found that a 3-month weight-training program helped patients make substantial gains in strength, mobility, balance, and body composition.
And while previous studies have examined resistance exercise during breast cancer surgery recovery, this program pumped up the intensity: Most women progressed to deadlifting 100 to 200 pounds, even though few had ever performed strength training before.
“Most of these patients can do a lot more than we think,” said principal investigator Colin Champ, MD, director of the Exercise Oncology and Resiliency Center at Allegheny Health Network in Pittsburgh.
The findings were presented at The American Society of Breast Surgeons (ASBrS) Annual Meeting, held in Seattle from April 29 to May 3.
Pumping Up the Intensity
For the analysis, Champ and his colleagues pooled the results of 3 small prospective studies of their strength conditioning program, including one that previously reported no worsening in patients’ lymphedema, and instead, showed signs of improvement.
The researchers evaluated program participants’ physical and functional gains and whether any of those parameters differed by the extent of their breast cancer surgery.
In total, there were 197 participants, including 85 who’d undergone mastectomies and 112 who’d had lumpectomies; 26 patients also had axillary lymph node dissection.
All of the women attended the same 3-month supervised strength-training program, starting at various points in their recovery process. Nearly half started at 3 months postdiagnosis.
According to Champ, the program addresses a full range of motion, with the exercise intensity building over a short period — similar to what professional athletes do in early training. The specific exercises include split squats, dumbbell presses, and dumbbell rows, done 3 days per week, for about 45-60 minutes.
Most participants, Champ said, start with deadlifting around 70 pounds (lifting weight from the floor to hip level). “If you can carry groceries, you can deadlift 60 or 70 pounds,” he noted.
Each month, the weight and sets increase, while the repetitions decrease.
“We just had a woman in her 70s who deadlifted about 200 pounds” as the program progressed, Champ said.
Benefits Regardless of Surgery Type
Women in the current analysis underwent baseline and post-program testing of body composition and functional parameters, including strength, mobility, and balance. Mastectomy patients (median age, 51 years) were younger than lumpectomy patients (median age, 59 years). They were also more likely to have had chemotherapy (45% vs 27%).
Overall, Champ’s team found that both surgery groups showed statistically significant improvements in muscle and body fat percentages over the course of the program, with muscle mass increasing by 1 percentage point on average and body fat declining by 1.5 percentage points.
Similarly, functional movement scores, grip strength, loads lifted, and balance skills also improved, with comparable benefits regardless of surgery type or whether lymph node dissection was performed.
By the end of the program’s third week, Champ said, most women could deadlift 100-pound weights. And by the 3-month mark, many were able to lift 200-pound loads.
Champ called the results empowering, and he hopes they help reframe the traditional mindset that intense strength training is too heavy a lift after breast cancer surgery.
A surgical oncologist who was not involved in the study agreed.
“This gives us something concrete to say to patients,” said Tina Hieken, MD, of the Mayo Clinic in Rochester, Minnesota. “We have more data to say it’s safe for you to exercise.’’
Hieken, who chaired the meeting’s scientific program committee, also noted that the findings pertain to women of all baseline fitness levels.
For her part, Hieken already encourages patients to walk for exercise and spend time outdoors — in part for the mental well-being benefits.
With patients facing so much uncertainty after a cancer diagnosis, she said, “this is something an individual can take control of.”
Champ and Hieken had no disclosures.
A version of this article first appeared on Medscape.com.