Clinical Exercise Prescription for Cardiovascular Health in Breast Cancer Survivors

Conventional treatments accessible to breast cancer survivors after diagnosis include cancer therapies with cardiotoxic effects such as trastuzumab and/or anthracycline-based chemotherapy, which can result in undesirable cardiac injuries known as cancer therapy-induced cardiotoxicity. Cancer therapy-induced cardiotoxicity is among a variety of cardiovascular comorbidities responsible for increased mortality in cancer survivors, and when accompanied by preexisting cardiovascular comorbidities, this detrimental side effect becomes a major health concern. Breast cancer survivors may be predisposed to this additional concern due to preexisting comorbidities related to cardiovascular diseases such as obesity, hypertension, and type 2 diabetes. Research in the rapidly emerging field of study which focuses on improving cardiovascular health in cancer survivors, known as cardio-oncology, reveals that exercise can improve the aforementioned comorbidities in clinical settings. However, the evidence has not been comprehensively evaluated to prescribe exercise as a clinical therapeutic option to improve cardiovascular health in breast cancer survivors. Therefore, the purpose of this review is to summarize the current evidence on the effects of exercise on cardiovascular outcomes in women with breast cancer at three different time points; before, during, and after cancer therapy. In addition, current knowledge gaps and future directions in the field of exercise science and cardio-oncology will be addressed.