{
  "abstract": "Objective To systematically review and investigate the dose–response (DR) relationship of aerobic exercise (AE), resistance exercise (RE) and combined (COMB) exercise programmes on cancer-related fatigue, lean mass, physical function and muscle strength in women with breast cancer during and following primary treatment.Design Systematic review with DR network meta-analysis (DR-NMA; CRD42023491118).Data sources CINAHL, Embase, LILACS, PubMed, SciELO, SPORTDiscus and Web of Science were searched from inception to 10 January 2024, with an updated search in April 2025.Eligibility criteria for selecting studies Randomised controlled trials evaluating COMB, RE or AE in women with breast cancer on the four specified outcomes.Results 64 trials (n=5156) were included. COMB was the most effective modality for improving fatigue and lean mass, and RE was the most effective for improving physical function and muscle strength. The smallest effective doses of COMB associated with significant changes in fatigue (standardised mean differences (SMD) 0.23 (95% CI 0.18 to 0.28)) and lean mass (SMD 0.30 (95% CI 0.22 to 0.38)) were 18 and 11 metabolic equivalents per week (METs.min/week), respectively. For RE, about 7–8 METs.min/week produced significant improvements in physical function (SMD 0.23 (95% CI 0.15 to 0.30)) and strength (SMD 0.24 (95% CI 0.20 to 0.29)). Fatigue benefits (SMD 0.58 (95% CI 0.46 to 0.69)) plateaued at ~1428 METs.min/week for COMB, whereas no plateau was observed for lean mass or strength across the evaluated dose range, with effects increasing throughout the available dose range.Conclusions COMB and RE were the most effective interventions across outcomes in women with breast cancer. Benefits for the outcomes assessed in this systematic review with DR-NMA were achieved with exercise doses as low as 10–40 min/week.PROSPERO registration number CRD42023491118.",
  "authors": [
    {
      "affiliations": [
        "Centre for Innovative Pleural Research, Institute for Respiratory Health, Nedlands, Western Australia, Australia",
        "Grupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil",
        "School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Programa de Pós-Graduação em Ciências da Saúde, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil"
      ],
      "name": "Pedro Lopez"
    },
    {
      "affiliations": [
        "Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany"
      ],
      "name": "Maria Petropoulou"
    },
    {
      "affiliations": [
        "Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Caparica, Almada, Portugal"
      ],
      "name": "Régis Radaelli"
    },
    {
      "affiliations": [
        "Grupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil",
        "Programa de Pós-Graduação em Ciências da Saúde, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil"
      ],
      "name": "Caroline B Silveira"
    },
    {
      "affiliations": [
        "Laboratório de Pesquisa do Exercício (LAPEX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil"
      ],
      "name": "Talita Molinari"
    },
    {
      "affiliations": [
        "Grupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil",
        "Curso de Medicina, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil"
      ],
      "name": "Cindranne Torres Muller"
    },
    {
      "affiliations": [
        "Grupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil",
        "Curso de Medicina, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil"
      ],
      "name": "Priscila Casara"
    },
    {
      "affiliations": [
        "Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Francesco Bettariga"
    },
    {
      "affiliations": [
        "School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia",
        "Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia"
      ],
      "name": "Favil Singh"
    },
    {
      "affiliations": [
        "Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, Netherlands"
      ],
      "name": "Laurien M Buffart"
    },
    {
      "affiliations": [
        "Grupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil",
        "Programa de Pós-Graduação em Ciências da Saúde, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil",
        "Curso de Educação Física, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil"
      ],
      "name": "Anderson Rech"
    }
  ],
  "title": "Optimising exercise prescription for cancer-related fatigue, lean mass, physical function and muscle strength in women with breast cancer: a systematic review with dose–response network meta-analysis",
  "uid": "9640e18d-6130-5d60-a8a7-a3e06fd155ff"
}