Most people diagnosed with breast cancer will have surgery, as it is considered the primary treatment. The type of surgery you may have depends on a variety of factors such as the size and location of the tumour, the stage of cancer, and the size of the breast. Surgery types can include lumpectomies, mastectomies, lymph node surgeries, and breast reconstruction surgeries. Some of these surgeries may also be done as part of the gender affirming process. Regardless of the type of surgery done, exercise is one of the best ways to help regain strength and mobility post-operatively. Exercise recommendations can be broken up into three phases: weeks 0-1, weeks 1-6, and weeks 6+.
During the first week after surgery, the focus of exercises should be to control swelling and begin gentle movement. It is important to remember that swelling is normal after surgery and that it is okay to start gentle exercises with swelling. You can also prop your arm up on a pillow while sleeping to help with the swelling. Deep breathing exercises also help with swelling and circulation. Gentle movements you can begin include shoulder blade squeezes, supported arm lifts, and hand pumping. Be mindful of your drain(s) and incision(s) when doing exercises and avoid excessive pulling to these areas.
During weeks 1-6 after surgery the focus of exercises should be on regaining range of motion. You should have full range of motion in your shoulder(s) by 6 weeks after surgery. Stretching and range of motion exercises will help you to get moving again. During these exercises, you should feel a little pulling or discomfort but no pain. Activities outside of exercise should include light housework like cooking, making the bed, or tidying up, but you should avoid lifting anything heavier than 10 lbs (example: vacuuming).
During week 6 and beyond after surgery the focus of exercises should be on regaining strength. You can do this by getting back to your old exercise routine or by starting a new one. If you are getting back to your old exercise routine, start with 25-50% of what you used to do and gradually build back up. For example, if you used to do bicep curls with 10 lbs dumbbells, start with 2-5 lbs. If you are starting a new strength routine, you can begin with resistance bands or dumbbells and gradually build up your strength by increasing the weight or repetitions.
While these general recommendations can be helpful, please see a physiotherapist to get an exercise program that is personalized.