Effects of Exercise on Depression and Anxiety in Breast Cancer Survivors: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

BACKGROUND: Numerous studies have investigated the effects of exercise on depression and anxiety in breast cancer survivors, yet the results remain inconsistent. The aim of this study was to investigate the effects of exercise on depression and anxiety in breast cancer survivors and to ascertain the optimal exercise regimen for this patient population. METHODS: A comprehensive search was conducted across Embase, PubMed, the Cochrane Library, Web of Science, and Scopus until 28 October 2023. A meta-analysis was conducted to quantify the standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS: A total of 25 studies met the inclusion criteria. Exercise significantly alleviated depression (SMD, -0.63, p < 0.0001) and anxiety (SMD, -0.49, p = 0.0002) in breast cancer survivors. Specifically, aerobic exercise (SMD, -0.44, p = 0.03) and multicomponent training (SMD, -0.86, p = 0.002) were found to be particularly effective in alleviating depression. However, only multicomponent training significantly alleviated anxiety (SMD, -0.66, p = 0.003) in breast cancer survivors. Additionally, multicomponent training conducted for ≥ 3 times per week (depression, SMD, -1.22, p = 0.006; anxiety, SMD, -0.93, p = 0.004) and ≤ 60 min per session (depression, SMD, -1.19, p = 0.002; anxiety, SMD, -0.85, p = 0.005) were deemed most effective in alleviating depression and anxiety in breast cancer survivors. CONCLUSIONS: Exercise significantly alleviated depression and anxiety in breast cancer survivors, with multicomponent training being the most effective intervention type. This meta-analysis provides clinicians with evidence to recommend that breast cancer survivors engage in multicomponent training more than three times per week, with each session lasting no more than 60 min, to alleviate depression and anxiety.