Differential Impact of Exercises on Quality-of-Life Improvement in Breast Cancer Survivors: A Network Meta-Analysis of Randomized Controlled Trials

Abstract

This study aimed to assess the effectiveness of various exercise interventions in enhancing the quality of life for breast cancer survivors. To achieve this, randomized controlled trials were identified from major electronic databases, focusing on the relationship between exercise and quality of life in breast cancer survivors. The primary outcome was the impact of exercise on quality of life 12 weeks after the intervention, with a secondary outcome comparing dropout rates between intervention groups and a regular care control group. The study protocol was registered with INPLASY (INPLASY202340007). A network meta-analysis of nine randomized controlled trials involving 725 participants was conducted, examining aerobic and strength training, aerobic activity, yoga, and strength exercise. Results showed that aerobic and strength training was the most effective intervention, significantly improving the quality of life of breast cancer survivors (1.31; 95% confidence interval: 0.49 to 2.12). Aerobic activity had a borderline effect (0.83; 0.03 to 1.63), while no exercise interventions were associated with an increased dropout risk compared to the control group (regular care). The study concluded that concurrent aerobic and strength training can improve breast cancer survivors' quality of life after 12 weeks of intervention without increasing dropout risk compared to regular care.

Keywords: aerobic and strength training; breast cancer survivors; exercise interventions; quality of life; randomized controlled trials.

Figure 1

Flow diagram for the study selection process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Figure 2

Network plots illustrate the effects of different exercise interventions on the improvement of quality of life in breast cancer survivors after 12 weeks. The size of each node and thickness of each line represents the number of trials included in the analysis.

Figure 3

Forest plots illustrating the standardized mean difference (SMD) in quality-of-life improvement between different exercise interventions and control groups among breast cancer survivors after 12 weeks of intervention.

Figure 4

Forest plots depicting the risk difference (RD) of dropout rates between different exercise interventions and control groups for breast cancer survivors after 12 weeks of intervention.