Combined Exercise is Best Exercise Modality to Improve Quality of life in Breast Cancer Survivors: A Systematic Review and Network Meta-Analysis

Globally, breast cancer is the most common cancer in women, posing a serious threat to women’s health. We investigated the different types of exercise( aerobic exercise (AE), resistance exercise (RE), and combined aerobic and resistance exercise (CO)) to increase the quality of life (QoL) in breast cancer patients. Meta-analysis was used to estimate the effect sizes, and subgroup analyses were conducted based on types of exercise. Risk of bias was assessed using the Cochrane Collaboration tool, and funnel plots were employed to evaluate publication bias. The inclusion criteria were met by 28 studies (31 trials), comprising 2038 patients for exercise (n = 1039) and control (n = 999). Meta-analysis showed exercise intervention enhanced QoL (0.44; 95% CI: 0.26–0.62) in patients with breast cancer. Subgroup analysis revealed improved QoL was greater with exercise intervention after adjuvant treatment (0.84; 95% CI: 0.46–1.21) than during adjuvant treatment (0.15; 95% CI: −0.01–0.30). CO (0.97; 95% CI: 0.33–1.61) was better than AE (0.42; 95% CI: 0.17–0.67) and RE (0.13; 95% CI: −0.05–0.31) in increasing QoL in patients. Values between subgroups were statistically significant for both timing of exercise (p = 0.0009) and type of exercise (p = 0.01). In conclusion, exercise intervention has a positive impact on the QoL of breast cancer patients. The enhancement in QoL was more pronounced in patients who exercised after adjuvant breast cancer treatment than during treatment. The most appropriate type of exercise to improve QoL is probably combined with AE and RE.