Impact of Exercise on QOL, Cardiorespiratory Function, and Inflammatory Markers in Breast Cancer Survivors: A Systematic Review and Meta-Analysis

PROBLEM IDENTIFICATION: Breast cancer is the most common cancer type in women globally. Although survival rates have improved, treatments cause lasting issues, including impaired cardiorespiratory fitness, chronic inflammation, and reduced quality of life (QOL). Exercise is recommended to alleviate these burdens, but evidence remains inconsistent regarding its effects on cardiorespiratory function, inflammatory markers, and QOL, with limited integrated evaluation. LITERATURE SEARCH: A systematic search was conducted in the Cochrane Central Register of Controlled Trials, Embase®, PubMed®, and Web of Science for articles published from database inception to April 15, 2025. DATA EVALUATION: The systematic review contained 32 studies involving 1,754 survivors. Literature quality was assessed using the Cochrane Risk of bias assessment tool 2, with analyses performed using RevMan, version 5.4, and Stata, version 18.0. SYNTHESIS: Exercise significantly improved peak oxygen consumption (weighted mean difference [WMD] = 1.22, p < 0.001) and QOL (general: WMD = 6.05, p < 0.001; breast cancer-specific: WMD = 5.13, p = 0.045). No significant effects were found on maximum oxygen consumption, C-reactive protein, interleukin-6, or tumor necrosis factor-alpha (p > 0.05). IMPLICATIONS FOR PRACTICE: Clinical practice should routinely recommend exercise to improve cardiopulmonary fitness and QOL in breast cancer survivors. Clinicians should incorporate exercise into rehabilitation plans and encourage participation, and future research should explore its specific effects on inflammatory markers.