Supervised Aerobic Dance Rehabilitation Improves Functional Capacity and Body Composition Across Obesity Strata in Breast Cancer Survivors Receiving Endocrine Therapy: A Four‐Group Factorial Ran domized Controlled Trial

Breast cancer survivors receiving adjuvant aromatase inhibitor therapy experience progressive deterioration in functional capacity and adverse body-composition changes, with obesity compounding these treatment-related sequelae. Whether supervised aerobic training produces comparable benefits across obesity strata in this population remains an open empirical question. Restoring functional capacity and preventing cancer-related disability are central goals of Physical and Rehabilitation Medicine, and supervised aerobic exercise is increasingly positioned as a structured rehabilitation strategy within survivorship care. This study aimed to (i) quantify training-induced changes in anthropometric and body-composition indices, (ii) evaluate functional aerobic capacity via the six-minute walk test (6MWT), and (iii) determine whether these responses differed between obese and non-obese participants. Sixty-eight women with hormone receptor-positive breast cancer receiving adjuvant letrozole were allocated in a 2×2 factorial randomized controlled trial (PACTR202512842728378) to four groups: experimental non-obese (ENOG, n=18), experimental obese (EOG, n=16), control non-obese (CNOG, n=16), and control obese (COG, n=18). Experimental participants completed 30 supervised aerobic dance sessions (50 min, three per week) over 10 weeks. Body composition was assessed by multi-frequency bioelectrical impedance analysis and functional capacity by the 6MWT. 6MWT distance improved substantially in both training groups (ENOG: +42.32 m; EOG: +49.45 m), while control groups showed negligible changes. Significant group-by-time interactions were observed for body mass and BMI. Importantly, the primary Time × Intervention × Obesity interaction was non-significant for 6MWT distance and fat mass, indicating that obesity status did not modify responsiveness to training. A 10-week supervised aerobic program substantially improves functional capacity and induces significant reductions in body mass and BMI in breast cancer survivors receiving aromatase inhibitor therapy, regardless of obesity status. These findings support the integration of supervised aerobic dance into cancer rehabilitation and Physical and Rehabilitation Medicine care pathways as a functional restoration strategy for breast cancer survivors, irrespective of obesity status.