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Exercise-based prehabilitation, initiated before surgery to enhance physical readiness, has shown benefits in other surgical settings. However, its specific impact on postoperative pain in breast cancer patients remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis evaluated the effectiveness of exercise-based prehabilitation in reducing postoperative pain in women undergoing breast cancer surgery. Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science up to June 2025 (search conducted prior to submission). Eligible studies were randomized controlled trials (RCTs) comparing exercise-based prehabilitation with usual care or educational interventions. The primary outcome was pain at one month post-surgery. Risk of bias was assessed using the Cochrane RoB 2 tool, and methodological quality via the TESTEX scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009519) were included in the qualitative synthesis, and three (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009157) in the meta-analysis. Interventions varied in duration (1\u20139 weeks), modality (aerobic, resistance, mobility, stretching), and supervision. Pain was measured using tools such as VAS, NPRS, EORTC QLQ-C30 and SPADI. Meta-analysis showed a small, non-significant effect (SMD = -0.24; 95% CI: -0.55 to 0.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.14). Heterogeneity was statistically low (I\u00b2 = 0%; 95% CI: 0% to 79%), although this estimate was based on only three studies and should not be interpreted as evidence of true consistency across trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exercise-based prehabilitation was reported as safe and feasible in the included studies, with a possible but non-significant benefit in reducing postoperative pain. Given the low certainty of evidence, further high-quality RCTs are needed to clarify its role in breast cancer surgical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12282-026-01899-4","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:03:27Z","timestamp":1785395007000},"page":"964-977","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of exercise based prehabilitation on postoperative pain in breast cancer patients: a systematic review with meta-analysis"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0518-8175","authenticated-orcid":false,"given":"Asier","family":"del Arco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0743-1283","authenticated-orcid":false,"given":"Celia","family":"Garc\u00eda-Chico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1598-8640","authenticated-orcid":false,"given":"Kayvan","family":"Khoramipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4568-320X","authenticated-orcid":false,"given":"Arkaitz","family":"Casta\u00f1eda-Babarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-3583","authenticated-orcid":false,"given":"Alejandro","family":"Santos-Lozano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8179-9253","authenticated-orcid":false,"given":"Jose","family":"Pinto-Fraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"1899_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1002\/ijc.35278","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. 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