A systematic review of multi-modal prehabilitation in breast cancer

Abstract

Abstract PurposeBreast cancer is the most prevalent malignancy in women. Prehabilitation may offer improvements in physical and psychological wellbeing among participants prior to treatment. This systematic review aimed to determine efficacy of prehabilitation in participants diagnosed with breast cancer. MethodsA systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Studies exploring the impact of prehabilitation in participants with breast cancer were included. Studies were assessed independently according to pre-eligibility criteria, with data extraction and methodological quality assessed in parallel. Results3184 records were identified according to search criteria, 14 articles were included. Articles comprised of quantitative randomised controlled trials (n=7), quantitative non-randomised studies (n=5), a qualitative study (n=1), and mixed method study (n=1). The majority of selected studies completed exercise programs (n=4) or had exercise components (n=2), with two focusing on upper-limb exercise. Two articles reported smoking cessation, with single studies reporting multi-modal prehabilitation (n=1), and complementary and alternative therapies (n=5). Mostly, prehabilitation improved outcomes including: physical function, quality of life, and psychosocial variables (P<0.05). The qualitative data identified preferences for multi-modal prehabilitation, compared to unimodal with interest in receiving support for longer. ConclusionsPrehabilitation for patients with breast cancer is an emerging research area that appears to improve outcomes, however ensuring adequate intervention timeframes, follow-up and population groups should be considered for future investigations. Implications for Cancer SurvivorsThe implementation of prehabilitation interventions for individuals diagnosed with breast cancer should be utilised by multidisciplinary teams to provide holistic care to patients as it has the potential to improve outcomes across the cancer care trajectory.