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April 16, 2026Breast Cancer Research0 citationsOpen Access

Exercise effects on lean body mass, muscle strength and functional performance in patients with metastatic breast cancer: the randomized controlled PREFERABLE-EFFECT study

EZEva M. ZopfGJGustav JoernakerDCDorothea Clauss

Key Points

  • To investigate the effects of an exercise program on muscle mass, strength, and functional performance in patients with metastatic breast cancer.
  • Randomized controlled trial design with 357 patients
  • Participants assigned to a 9-month supervised exercise program or control
  • Assessment of body composition, muscle strength, and functional performance at baseline, 3 and 6 months
  • Statistical analyses using linear mixed models for repeated measures.
  • Significant increase in whole body lean mass at 3 months (0.79 kg) and appendicular skeletal muscle mass at both 3 (0.60 kg) and 6 months (0.48 kg) compared to control
  • Improvements in lower body strength at 3 months (18.32 kg) and 6 months (34.22 kg) compared to control
  • Functional performance, including balance, improved with exercise compared to the control group.

Abstract

Low skeletal muscle mass and strength are common in patients with metastatic breast cancer (mBC) and have been associated with treatment toxicities and poor prognosis. The PREFERABLE-EFFECT study (NCT04120298) investigated exercise effects on body composition, muscle strength, and functional performance (secondary outcomes) in patients with mBC. Patients with mBC (n = 357) were randomized to a 9-month supervised aerobic, resistance and balance exercise program (EX) or control. Body composition (subset n = 66), lower body strength (subset n = 126), handgrip strength and functional performance were assessed at baseline, 3 and 6 months. Changes between groups were compared using linear mixed models for repeated measures. EX significantly increased whole body lean mass at 3 months (between-group difference = 0.79 kg, 95%CI 0.14; 1.44, effect size = 0.14), appendicular skeletal muscle mass at 3 months (0.60 kg, 0.22; 0.97, ES = 0.19) and 6 months (0.48kg, 0.09; 0.87, ES = 0.15), and lower body strength at 3 months (18.32 kg, 7.58; 29.06, ES = 0.44) and 6 months (34.22 kg, 23.0; 45.45, ES = 0.83) compared to control. EX also improved functional performance, including balance, compared to control. The results support the promotion of supervised exercise for patients with mBC, with beneficial effects on skeletal muscle mass, muscle strength and physical performance. The PREFERABLE-EFFECT study was registered on ClinicalTrials.gov on October 9, 2019 (NCT04120298).

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Cite This Study

Zopf et al. (2026) studied this question.

synapsesocial.com/papers/69e07c1e2f7e8953b7cbd820https://doi.org/10.1186/s13058-026-02235-6
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