Updated systematic review and meta-analysis: taking the next step in physical activity behavioral interventions for...

To provide an updated review of the literature on physical activity (PA) intervention studies, their characteristics, and their effect size estimates for PA behavior change among early post-treatment breast cancer survivors (BCS).

Eligible studies were published between 2014-2025 in English, were quasi- or randomized controlled trials, studied BCS ≤ 5 years post-treatment, tested a PA intervention, and assessed PA behavior. We searched PubMed, APA PsycINFO, Embase, and CINAHL (latest search October 2025; CINAHL June 2020). Extracted data included study, participant, intervention, and outcome descriptors. The ROB 2 assessed risk of bias. A random effects model on post-intervention Cohen's d standardized mean differences (SMD) values meta-analysis was performed.

Twenty-two RCTs with a total sample size of 2,390 (mean = 109, range = 26-692) were included. All included BCS were female, were on average 57 years old, and predominantly (> 60%) non-Hispanic White. Most study populations were mixed in terms of cancer stage and treatment type. Intervention duration ranged from 6-104 weeks. All studies except one were partially or fully home-based. All behavioral counseling interventions were theory-based. The overall SMD was d = 0.36 (95% confidence interval: 0.22, 0.50) in favor of the intervention. Two studies had some concerns for risk of bias; all others were rated as low.

The present updated review found a small-to-moderate positive effect of PA interventions on PA behavior change among early post-treatment BCS. We note some shifts in the participant samples and study design since the originally published review. Practical implications for improving the reporting of future research include following established reporting guidelines to enhance reporting transparency, which would allow for more precise quantification of specific intervention effects and deeper contextual understanding of this body of work.