Effect of physical exercise on the quality of life of women surviving breast cancer: systematic review with meta-analysis of randomized clinical trials

Introduction: Women surviving breast cancer (WSBC) may experience reduced quality of life (QoL) due to disease-associated manifestations and undergone treatment. Engagement in physical exercise (PE), and subsequent effects on physical capacity and social and emotional wellbeing, are known to enhance QoL.
Method: this systematic review meta-analysed the impact of PE, compared to respective control groups, on QoL in WSBC. Randomized clinical trials published up to December 2023 were searched in PubMed Medline, PsycInfo, EMBASE, Web of Science, LILACS, Cochrane Central, Scopus, and Google Scholar. Selected papers were catalogued in Endnote® and remaining documents exported to Rayyan®. Data analyses utilized the RoB2 tool, Revman®, and GRADE for classification of certainty of evidence. Values of change in measurements between baseline and post-intervention were meta-analysed, with standardized mean differences calculated as effect size.
Results: 3,313 documents were identified, with 36 meeting our eligibility criteria, and 35 quantitatively analysed. The meta-analysis revealed that PE, irrespective of modality, significantly improved QoL, as assessed by the Short Form Health Survey 36 (SF-36) global health perception scale (SMD= 0.43; CI95%: 0.12 to 0.73; p=0.006), FACT-G (SMD= 0.56; CI95%: 0.13 to 0.99; p≤0.01), FACT-B (SMD= 0.73; CI95%: 0.38 to 1.08; p=0.0003), and EORTC QLQ-C30 (Global health, SMD = 0.98; 95% CI: 0.49 – 1.47; p<0.00001). Subgroup analyses showed that combination of aerobic and resistance exercises yielded the most significant increase in QoL. SF-36 subdomains showed moderate to high certainty of evidence.
Conclusion: PE is effective in improving QoL in WSBC, particularly when combining aerobic and strength exercises. Robust public policies must encourage PE not only to reduce cancer risk but also to promote QoL improvement in WSBC.