Exercise Interventions in Metastatic Breast Cancer: A Clinical Update

Structured exercise programs produced measurable improvements in physical function and quality of life in patients with metastatic breast cancer receiving systemic therapy, offering an actionable supportive-care option for oncology teams.

Benefits were observed during treatment and included objective gains tied to mobility and daily activities, supporting exercise as an adjunct to systemic care for appropriately selected patients.

Earlier evidence confined exercise benefits mainly to early-stage disease; recent reports extend clinically meaningful endpoints into metastatic cohorts, shifting the evidence frame toward measurable effect rather than theory. The interventions were supervised programs combining aerobic and resistance training delivered during systemic therapy and assessed with objective endpoints — lean mass, muscle strength, and performance-based tests — alongside patient-reported fatigue and quality-of-life measures.

Across cohorts, programs showed increases in lean mass, gains in muscle strength, and improvements on performance tests such as walking speed and timed-up-and-go, signaling preserved or improved mobility during treatment. Study designs shared strengths that bolster interpretation: supervised sessions, combined aerobic and resistance prescriptions, objective endpoints, and within- and between-group comparisons where feasible. Sample sizes remain small to moderate for metastatic-specific trials, so broad generalizability across all metastatic subgroups is not asserted.

Exercise was generally well tolerated during systemic therapy, with adverse events uncommon and typically manageable and no clear signal of compromised treatment delivery or increased interruptions. Safety and feasibility data reported reduced fatigue and improved quality-of-life scores, and programs were delivered alongside systemic regimens without reported increases in dose reductions or treatment delays in the cohorts covered. Feasibility depended on supervised delivery and participant selection, which influenced attrition and adherence.

Routine consideration of structured exercise as part of comprehensive supportive-care planning is a practical next step for teams managing ambulatory patients with metastatic breast cancer.

Key Takeaways:

• Structured exercise programs produce measurable physical and quality-of-life benefits in ambulatory metastatic breast cancer patients receiving systemic therapy.
• Ambulatory patients receiving systemic treatment who can participate in supervised exercise are the primary beneficiaries.
• Integration of exercise into supportive-care pathways is reasonable where services, referral workflows, monitoring capacity, and trial enrollment can be pragmatically arranged.