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A systematic review of multimodal prehabilitation in breast cancer.

Toohey, Kellie; Hunter, Maddison; McKinnon, Karen; Casey, Tamara; Turner, Murray; Taylor, Suzanne; Paterson, Catherine


Kellie Toohey

Maddison Hunter

Karen McKinnon

Tamara Casey

Murray Turner

Suzanne Taylor

Catherine Paterson


Breast 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 the efficacy of prehabilitation in participants diagnosed with breast cancer. A 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. 3184 records were identified according to our search criteria, and 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 a 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. Five articles reported complementary and alternative therapies (n = 5). Two articles reported smoking cessation (n = 2), with a single study reporting multi-modal prehabilitation (n = 1). Mostly, prehabilitation improved outcomes including physical function, quality of life, and psychosocial variables (P < 0.05). The qualitative data identified preferences for multimodal prehabilitation, compared to unimodal with an interest in receiving support for longer. Prehabilitation for patients with breast cancer is an emerging research area that appears to improve outcomes, however, ensuring that adequate intervention timeframes, follow-up, and population groups should be considered for future investigations. The 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.


TOOHEY, K., HUNTER, M., MCKINNON, K., CASEY, T., TURNER, M., TAYLOR, S. and PATERSON, C. 2023. A systematic review of multimodal prehabilitation in breast cancer. Breast cancer research and treatment [online], 197(1), pages 1-37. Available from:

Journal Article Type Review
Acceptance Date Oct 2, 2022
Online Publication Date Oct 21, 2022
Publication Date Jan 1, 2023
Deposit Date Nov 3, 2022
Publicly Available Date Nov 3, 2022
Journal Breast cancer research and treatment
Print ISSN 0167-6806
Electronic ISSN 1573-7217
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 197
Issue 1
Pages 1-37
Keywords Exercise; Nutrition; Nursing; Psychology; Wellness; Cancer care
Public URL
Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of this document.


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