Exercise as Supportive Care During Breast Cancer Treatment: A Narrative Review of Strategies to Reduce Cancer-Related Fatigue and Improve Quality of Life

Abstract

Background. Cancer-related fatigue (CRF) and deterioration in health-related quality of life (HRQoL) are frequent consequences of breast cancer treatment and may compromise physical functioning and daily activity. Exercise has therefore become an important component of supportive oncology. Aim. To critically evaluate exercise interventions used during active breast cancer treatment, with emphasis on CRF and HRQoL. Material and methods. A targeted narrative review of PubMed-indexed studies and major clinical guidelines was undertaken, prioritizing guidelines, systematic reviews, meta-analyses, and randomized controlled trials involving women receiving chemotherapy or radiotherapy. Results. Exercise reduces CRF, with evidence supporting aerobic, resistance, and combined training. Supervised combined programs often produce larger or more consistent benefits, although effective home-based interventions have also been demonstrated. Effects on HRQoL are positive overall but less uniform than effects on fatigue and physical fitness. Mechanistic studies may suggest preservation of skeletal-muscle function and modulation of inflammatory pathways. Evidence that exercise improves tumour response or survival during treatment remains insufficient. Conclusions. Individualized aerobic and resistance exercise represents an evidence-based supportive intervention during breast cancer treatment, particularly for CRF and functional deterioration.