Research, Resource & Education

Table of Contents

This is the 8th book on home exercise guides, which includes an extra chapter on breast cancer, including exercise benefits and precautions. It has been proven that exercise and nutrition are two of the main factors that you can control for a healthy lifestyle. Many people do not know how to start or progress an exercise program. There are hundreds of pictures for beginner, intermediate and advanced exercise programs, as well as a list of equipment that you can use in the home.

It is recommended that if you’re new to exercising or have pre-existing health concerns, you should consult your physician before beginning any exercise program. This will ensure that you receive personalized recommendations tailored to your unique health status, and potentially prevent any complications that may arise.

It is important to remember that the information presented here and in books is of an educational nature and should not be used in lieu of medical advice from your doctor and healthcare team.

Most of the breast cancer research is from the National Cancer Institute including Side Effects/Late Effects, Treatments and Nutrition section.

Breast Cancer / Lymphedema
Exercise Benefits and Precautions
Plus
Home Exercise & Nutrition Guide

Please see Home Exercise Guide for the exercise & nutrition table of content and more about the Fitness & Nutrition Series.  

The information below in is addition to the Fitness & Nutrition Book. 

BREAST CANCER & LYMPHEDEMA

Breast Cancer and Exercise

What is breast cancer, How does it spread, Stage Groups, Risk factors, Protective factors 

BREAST CANCER TYPES:  Ductal carcinoma in situ (DCIS), Lobular carcinoma in situ (LCIS), Invasive ductal carcinoma (IDC), Invasive lobular carcinoma (ILC), Rare cancers, Inflammatory breast cancer, Paget Disease of the Breast Screening  

LAB TESTS: screening mammogram, diagnostic mammography, Ultrasound, MRI, Ductography, PET scan, biopsy 

PATHOLOGY: Testing and Diagnosis Tumor Grade/Differentiating Cells, Nottingham grading system

STAGING:  TNM Staging System, Stage 0-IV, Localized, Regional, Distant, Unknown

PROGNOSTIC MARKERS:  Margins or ink, HER2/neu gene, Estrogen receptor (ER), Progesterone receptor (PR), Ki-67, S-phase fraction, Lymphovascular Invasion, Multigene tests, Molecular subtypes

GENES: Tumor Suppressor Gene, BRCA1 and BRCA 2, PALB2, CHEK2, ATM

BREAST SURGERIES: Mastectomy, Breast Conserving Lumpectomy, Considerations for Breast Conserving surgery, Nipple-Sparing Mastectomy, Total Mastectomy or Simple Mastectomy, Modified Radical Mastectomy, Considerations with Mastectomy, Considerations with Mastectomy and Reconstruction, Compare the Types of Breast Surgery 

BREAST RECONSTRUCTION :  Factors – Timing, Factors – Choice, Reconstruction with Implants, Reconstruction with Autologous Tissue 

BREAST IMPLANTS & TISSUE EXPANDERS 

TISSUE FLAP SURGERY:  Autologous tissue, Reconstruction with Autologous Tissue, Abdomen: TRAM flap, Abdomen: DIEP flap, Abdomen: SIEA flap, Back: Latissimus dorsi flap (LAT flap), Buttock (gluteal) flap, Thigh flaps (TUG) and (IGAP), Nipple reconstruction

SENTINEL & AXILLARY LYMPH NODES / DISSECTION:  Sentinel lymph node, Sentinel lymph node biopsy (SLNB), Surgery, SLNB and Breast Cancer, Risks of SLNB, Axillary lymph nodes (ALND), ALND and risks, 3 Levels of ALND, Nerves that may be damaged during surgery 

LYMPH NODES & LYMPHEDEMA:  Lymph nodes, Lymphatic System, Anatomy of lymphatic system, Lymphedema and Cancer, Stages of Lymphedema, Possible Signs of Lymphedema, Preventative Measures, Treatment, Axillary Reverse Mapping (ARM) 

RISKS AFTER BREAST SURGERY: Axillary Web Syndrome (Cording) Scar Tissue / Adhesions / Myofascial Release Seroma / Compression 

CANCER TREATMENTS: Chemotherapy, Radiation, Hormone therapy, Targeted therapy 

SIDE EFFECTS & LATE SIDE EFFECTS:  Possible Cause and Ways to Manage 

CANCER & EXERCISE: Guidelines including: Benefits, Risks, When to Avoid or Modify Exercise Routine Starting an Exercise Program Guidelines for Type of Exercise, Including Balance, Aerobic/Endurance, Strengthening, Flexibility/ROM 

EXERCISE CONTRAINDICATIONS / PRECAUTIONS AFTER SURGRY:  Tram Flap, Latissimus dorsi flap, DIEP flap, Tissue expander Lymphedema and Exercise Axillary node dissection Peripheral neuropathy Nerves that may be damaged during surgery Things to do and to avoid in the first 2 weeks Post op healing concerns Exercise and Resistance (Weights or Bands) 

POST MASTECTOMY EXERCISES & RECOMMENDATIONS

EATING HINTS Before, During and After Cancer Treatments (National Cancer Institute)

Who is this Book for?
Who is this Book not for?

This book is for:
*  Those that currently have or are breast cancer survivor that
          Are currently or may have had treatments, such as chemotherapy or radiation
          Are planning or have had surgeries and/or at risk for lymphedema.
*  The beginner who has never exercised before or the individual that has mastered the basics, but wants to know how to advance to the next level.
*  The personal trainer, physical therapist, or other coaches who would like to know more about precautions with breast cancer patients or clients.

This book is not for or may need modification:
*  Chronic or acute disorders/injury’s that is not being followed by a health care professional. This book can be used in conjunction with a rehab program.
*  If you are over 40 and have never exercises before, it is advised that a physician clears you first.
*  Undiagnosed pain
*  The person that does not feel they can safely modify their individual program, although can be used in conjunction with rehab or coaches/personal trainers.
*  People with the following issues that have been cleared by an MD for an exercise program or in conjunction with rehab. These issue may be addressed in future volumes: Cardiopulmonary, Arthritis, Diabetes, Autoimmune disorders

Sample Pages

References

Breast Cancer and Breast Cancer Types
CDC – Center of Disease Control and Prevention
CDC (1) – What is Breast Cancer? https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm
Mayo Clinic: Mayoclinic.org
Mayo Clinic: Ductal carcinoma in situ (DCIS) https://www.mayoclinic.org/diseases-conditions/dcis/symptoms-causes/syc-20371889
Mayo Clinic: Invasive lobular carcinoma https://www.mayoclinic.org/diseases-conditions/invasive-lobular-carcinoma/symptoms-causes/syc-20373973
Mayo Clinic: Lobular carcinoma in situ (LCIS) https://www.mayoclinic.org/diseases-conditions/lobular-carcinoma-in-situ/symptoms-causes/syc-20374529
NCBI – Diversity of Breast Carcinoma https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4689326/
NIH – NCI – National Cancer Institute
NIH – NCI – IDC definition https://www.cancer.gov/publications/dictionaries/cancer-terms/def/invasive-ductal-carcinoma
NIH – NCI (1) – Breast Treatment (professional) https://www.cancer.gov/types/breast/hp/breast-treatment-pdq
NIH – NCI (2) Treatment (patient) https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#_181
NIH- NCI – ILC definition- https://www.cancer.gov/publications/dictionaries/cancer-terms/def/invasive-lobular-carcinoma
NIH NCI – Paget https://www.cancer.gov/types/breast/paget-breast-fact-sheet
NIH – NCI – Inflammatory Breast Cancer https://www.cancer.gov/types/breast/ibc-fact-sheet
Screening
NIH – NCI (3) Breast Changes and Conditions https://www.cancer.gov/types/breast/breast-changes
NIH – NCI (4) How Cancer Is Diagnosed https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis
Pathology: Testing & Diagnosis, Staging and Prognostic Markers
American Cancer Society: Understanding Your Pathology Report: Breast Cancer https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-pathology-report/breast-pathology/breast-cancer-pathology.html
Breast Cancer Rehab Course – https://klosetraining.com/
BreastCancer.org: Rate of Cell Growth https://www.breastcancer.org/symptoms/diagnosis/rate_grade
NCBI – NIH Ki-67 as a prognostic marker https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5250608/
NCBI – PMC Lymphovascular invasion https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078671/ 
NIH – NCI (1) – Breast Treatment (professional) https://www.cancer.gov/types/breast/hp/breast-treatment-pdq
NIH – NCI (2) Treatment (patient) https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#_181
NIH – NCI (5) Tumor Grade https://www.cancer.gov/about-cancer/diagnosis-staging/prognosis/tumor-grade-fact-sheet
NIH – NCI (6) Staging https://www.cancer.gov/about-cancer/diagnosis-staging/staging
Genes
American Cancer Society: How Does Breast Cancer Start? https://www.cancer.org/cancer/breast-cancer/about/how-does-breast-cancer-form.html
American Cancer Society: Understanding Your Pathology Report: Breast Cancer https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-pathology-report/breast-pathology/breast-cancer-pathology.html
BreastCancer.org: Abnormal PALB2 Gene Increases Breast Cancer Risk More Than Previously Thought https://www.breastcancer.org/research-news/abnormal-palb2-gene-increases-risk
Britannica: Tumour suppressor gene https://www.britannica.com/science/tumor-suppressor-gene
FORCE-Facing Our Risk of Cancer Empowered, Inc: No one should face hereditary cancer alone https://www.facingourrisk.org/understanding-brca-and-hboc/information/hereditary-cancer/other-genes/basics/atm.php
My support 360: CHEK2 Gene Mutations https://mysupport360.com/associations/genes/chek2-gene-mutations/
NCBI: Current perspectives on CHEK2 mutations in breast cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439543/
NHI – NCI (7)- BRCA Mutations https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#what-are-brca1-and-brca2
Breast Surgeries
NIH NCI (8) https://www.cancer.gov/types/breast/surgery-choices
Department of Health NY: Breast Cancer Treatment – What You Should Know
https://www.health.ny.gov/publications/0401/#treatment_options
Breast Reconstruction, Breast Implants, Tissue Flap Surgery FDA’s Breast Implants page. https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/default.html
John Hopkins Medicine – Tissue Expander YouTube Video https://www.youtube.com/watch?v=J9B23xnIoTw
John Hopkins Medicine – Tissue Expanders https://www.hopkinsmedicine.org/breast_center/treatments_services/reconstructive_breast_surgery/tissue_expanders.html
Mayo Clinic – Breast reconstruction with flap surgery – https://www.mayoclinic.org/tests-procedures/breast-reconstruction-flap/about/pac-20384937
NIH NCI (10) https://www.cancer.gov/types/breast/surgery-choices
NIH NCI (11) https://www.cancer.gov/types/breast/reconstruction-fact-sheet 
Sentinel & Axillary Lymph Nodes / Dissection, Lymph Nodes & Lymphedema and Axillary Reverse Mapping (ARM)
American Cancer Society – Lymph Node Surgery for Breast Cancer https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer/lymph-node-surgery-for-breast-cancer.html Medical gallery of Blausen Medical 2014″. WikiJournal of Medicine
NIH NCI (11) https://www.cancer.gov/types/breast/surgery-choices/lymphedema
NIH NCI (12) https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq
NIH NCI (13) https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet
NIH – National Library of Medicine. Axillary Reverse Mapping (ARM): Where to G https://pubmed.ncbi.nlm.nih.gov/29961238/
NIH – National Library of Medicine. Axillary Reverse Mapping (ARM) Technique (ARM) https://clinicaltrials.gov/ct2/show/NCT03109522
Pink Ribbon Program© https://www.pinkribbonprogram.com/
Summit Education: Oncology Rehab Dec 12, 2019 – https://summit-education.com/
UPMC Axillary Lymph Node Dissection https://www.upmc.com/locations/hospitals/magee/services/magee-womens-cancers/breast-cancer-program/treatment/breast-cancer-surgery/axillary-lymph-node
Wikipedia – Axillary Lymph Nodes – https://en.wikipedia.org/wiki/Axillary_lymph_nodes
Wiki McMaster: Breast Cancer https://wiki.mcmaster.ca/LIFESCI_4M03/_detail/screen_shot_2017-10-02_at_5.51.59_pm.png?id=group_1_presentation_1_-_breast_cancer
Cording Or Axillary Web Syndrome (AWS), Scar Tissue / Adhesions / Myofascial Release, Seroma / Compression
Breast Cancer Resource Center: Benefits of Myofascial Release Therapy after Mastectomy & Lumpectomy https://bcrc.org/benefits-myofascial-release-therapy-mastectomy-lumpectomy/
Breastcancer.org Axillary Web Syndrome (Cording) https://www.breastcancer.org/treatment/side_effects/aws
BreastCancer.org: Scar Tissue Formation https://www.breastcancer.org/treatment/side_effects/scar_tissue
Klose: Breast Cancer Rehabilitation https://klosetraining.com/
NCBI: Seroma formation after surgery for breast cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC543447/
NCBI: An evaluation tool for Myofascial Adhesions in Patients after Breast Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844553/#:~:text=Breast%20and%20axillary%20surgery%20and,level%20and%20deeper%20myofascial%20structures.
NCBI: PMC: Atypical presentation of axillary web syndrome (AWS) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178020/
NCBI: PMC: Cording Following Treatment for Breast Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786257/
NIH: NCATS: Mondor Disease: https://rarediseases.info.nih.gov/diseases/7054/mondor-disease
Pink Ribbon Program© https://www.pinkribbonprogram.com/
Summit Education: Oncology Rehab Dec 12, 2019 – https://summit-education.com/
Web MD: Adhesions, General and After Surgery https://www.webmd.com/a-to-z-guides/adhesion-general-post-surgery#1 
Chemotherapy
Cancer.gov publication – Chemotherapy and You https://www.cancer.gov/publications/patient-education/chemotherapyand-
you.pdf
NIH NCI (14) Chemotherapy https://www.cancer.gov/about-cancer/treatment/types/chemotherapy
Radiation
NIH NCI (15) Radiation https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy
NIH NCI (16) Radiation Therapy and You. https://www.cancer.gov/publications/patient-education/radiationttherapy.pdf
Hormone Therapy
NIH NCI (17) https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#_185
Pink Ribbon Program© https://www.pinkribbonprogram.com/
Targeted Therapy
NIH NCI (17) https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#_185
Side Effects and Late Side Effects
NIH (NCI) https://www.cancer.gov/about-cancer/treatment/side-effects
Exercise
American Cancer Society – Physical Activity and the Cancer Patient – https://www.cancer.org/treatment/survivorship-duringand-
after-treatment/staying-active/physical-activity-and-the-cancer-patient.html
Cancer Research UK – Exercise guidelines for Cancer Patients
https://www.cancerresearchuk.org/about-cancer/coping/physically/exercise-guidelines
CETI: Pilates https: //www.thecancerspecialist.com/
Clinical Exercise Physiology, Ehrman, Jonathan, et al., Human Kinetic, 2003
Dana Farber – https://www.dana-farber.org/
Eating Hints: Before, during, and after Cancer Treatment by the National Cancer Institute
https://www.cancer.gov/publications/patient-education/eatinghints.pdf
Klose Training ©: Breast Cancer Rehabilitation – https://klosetraining.com/
NCBI: Scapular winging: anatomical review, diagnosis, and treatments:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684151/
NIH NCI (12) https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq
Pink Ribbon Program© – https://www.pinkribbonprogram.com/
WikiMedia Commons: https://commons.wikimedia.org/wiki/Category:Images