Effects of Resistance Training on Breast Cancer-Related Lymphedema: A Meta-Analysis

To determine the effectiveness of resistance training (RT) on the incidence, severity, and objective physiological indicators of breast cancer-related lymphedema (BCRL), and to assess its impact on limb function.

A systematic search was conducted in PubMed, Embase, Web of Science, Medline, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang, VIP Information Co., Ltd. (VIP), and the Chinese Medical Journal full-text database from inception to August 1, 2025.

Randomized controlled trials involving adults with breast cancer who were at risk of or had established BCRL, and comparing RT with nonresistance exercise, usual care, or alternative management approaches. A total of 38 Randomized controlled trials involving 4843 patients were included.

Two reviewers independently screened the studies, extracted data using a standardized form, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool.

Statistical analyses were performed using RevMan 5.4. RT significantly reduced the incidence of lymphedema (odds ratio [OR]=0.25, 95% CI, 0.19-0.32) and moderate-to-severe lymphedema (OR=0.21, 95% CI, 0.16-0.29). It also decreased upper limb volume (mean difference [MD]=-152.37, 95% CI, -153.81 to -150.94) and circumference differences (MD=-1.51, 95% CI, -1.62 to -1.41), while improving lymphatic drainage volume (MD=5.03, 95% CI, 4.67-5.39) and the rate of excellent or good limb function (OR=4.23, 95% CI, 2.72-6.57). Subgroup analyses revealed that a short-duration, high-frequency training paradigm and combined therapy regimens produced the most pronounced protective effects.

RT is a safe and effective intervention that significantly reduces the risk and severity of BCRL while improving limb volume, lymphatic function, and shoulder mobility. For optimal benefit in clinical practice, progressive RT should be delivered using a "short-duration, high-frequency" model integrated into combined therapy protocols.