By Lila Rouland | Published on October 27, 2025 | 3 min readBreast
cancer, affecting more than
2.3 million women each year, often leads to lasting
aftereffects well beyond treatment. Among them,
cancer-related cognitive
impairment (CRCI) affects up to
70% of patients, with symptoms such as memory
loss, difficulty concentrating, and mental slowing—often described as “chemo
brain.” Even when mild, these cognitive issues can persist for several years,
impacting return to work, autonomy, and mental health.
The
mechanisms involved include
neurotoxic treatments (chemotherapy, hormone
therapy, radiotherapy) as well as the biological stress of the cancer itself.
In this context, physical exercise—already known to enhance cognition in the
general population—could represent a relevant non-pharmacological intervention.
However, earlier studies often lacked methodological rigor or used inadequate
measurement tools.
Study
objective: To evaluate the effect of exercise programs on cognitive function in breast
cancer survivors through a systematic review and meta-analysis of randomized
controlled trials (RCTs), focusing on specific, validated cognitive
assessments.
What
concrete cognitive benefits for survivors?
Methodology: The analysis included 11 randomized controlled trials involving 890 women with
breast cancer (stages 0–IV), either undergoing or having completed treatment.
Exercise programs included aerobic, resistance, combined, or mind-body
activities (e.g., Qigong), lasting 8–24 weeks, with 2–5 sessions per week.
Cognitive function was assessed using standardized neuropsychological tests
(TMT, HVLT-R, Stroop, etc.) and self-reported questionnaires (FACT-Cog,
PROMIS).
Main
results show that exercise significantly improves:
- Attention and working memory
(SMD = 0.43; p < 0.001)
- Executive functions such as
mental flexibility (SMD = –0.29; p < 0.001)
- Perceived cognitive abilities
(SMD = 0.95; p = 0.003)
- Self-reported cognitive
complaints (SMD = –0.75; p < 0.001)
However,
no significant effects were observed for:
- Learning
memory
- Processing
speed
- Verbal
fluency
The effects
were generally more pronounced with
aerobic or
combined interventions, and
benefits were clearer when cognition was a
primary study outcome. Positive
effects were also linked to
reduced fatigue and anxiety, reinforcing the idea
of a multifactorial mechanism of action.
Could
physical exercise become a standard prescription in post–breast cancer care?
Post-cancer
cognitive disorders represent a major public health issue, impacting quality of
life, return to work, and mental well-being. This meta-analysis demonstrates
that
regular physical exercise—especially at
moderate to vigorous
intensity—improves several key aspects of cognition in breast cancer survivors.
Main
conclusion: Exercise has a positive effect on cognitive resilience, with clinically
meaningful improvements in attention, working memory, and executive function.
Study limitations:
- Heterogeneity
of assessment tools
- Few studies with cognition as
the primary endpoint
- Limited data on patients
undergoing active treatment or with metastatic cancer
Future
directions: Upcoming studies should use standardized tools combining both objective and
subjective assessments, include cardiorespiratory fitness as a key variable,
and explore multimodal approaches combining cognitive training with physical
activity.
Read next: Combined exercise: a winning strategy for cardiorespiratory fitness after breast cancer
About the author – Lila Rouland
Doctor of Oncology, specialized in Biotechnology and Management
