Overview

This single-center, parallel-group randomized controlled trial (RCT) will compare two timings for initiating specific exercise therapy after breast cancer surgery. The study tests whether early initiation (within the first postoperative week) versus delayed initiation (at 3 weeks postoperative) results in superior upper limb function at 6 months as measured by the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcomes include pain intensity (Visual Analog Scale, VAS) and wound-related complications such as drainage time and hematoma incidence.

Eligibility

Inclusion Criteria:

• Women aged 18-65 years.
• Scheduled to undergo breast cancer surgery with axillary node dissection.
• At risk for upper limb morbidity based on preoperative assessment.
• Able to provide informed consent and complete study questionnaires.
• Willing and able to attend scheduled physiotherapy sessions and follow-up evaluations.

Exclusion Criteria:

• Diagnosis of recurrent or metastatic breast cancer.
• Concurrent participation in another rehabilitation intervention or clinical trial.
• Severe comorbidities (e.g., uncontrolled cardiovascular disease, severe orthopedic conditions) that preclude safe participation.
• History of previous shoulder surgery or chronic upper extremity musculoskeletal disorders unrelated to breast cancer treatment.
• Inability to understand or complete study materials in English.
• Pregnancy or lactation.