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Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
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Do Combined Resistance and Aerobic Exercise Programs Cause an Interference Effect in Women with Breast Cancer? A
Pedro Lopez1,2,3,4, Anderson Rech5,6,7, Maria Petropoulou8
1Grupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil. pedro.lopezdacruz@resphealth.uwa.edu.au.
Sports Medicine (Auckland, N.Z.)
|February 20, 2026
Summary
For breast cancer patients, resistance exercise (RE) alone may be better than combined exercise (COMB) for maintaining lean mass and muscle strength. This approach helps minimize potential interference effects during treatment.
Area of Science:
- Exercise oncology
- Cancer rehabilitation
- Breast cancer treatment
Background:
- Exercise medicine is crucial for breast cancer patients, with resistance exercise (RE) improving muscle strength and aerobic exercise (AE) enhancing cardiorespiratory fitness.
- Combining resistance and aerobic exercise (COMB) is hypothesized to cause an interference effect, potentially compromising gains in lean mass and muscle strength in cancer patients.
Purpose of the Study:
- To investigate the interference effect of COMB versus RE on fatigue, lean mass, physical function, and muscle strength in women with breast cancer.
- To examine demographic, clinical, and exercise prescription moderators influencing these outcomes.
Main Methods:
- A systematic search of seven databases was conducted up to January 2024, with an updated search in April 2025 (PROSPERO CRD42023491118).
- Eligible randomized controlled trials involving women with breast cancer were analyzed using a random-effects network meta-analysis.
- Primary outcomes included cancer-related fatigue, lean mass, physical function, and lower-limb muscle strength, with an interference effect indicated by differences >0.20 standardized mean difference (SMD).
Main Results:
- Both RE and COMB similarly reduced fatigue compared to controls. RE showed greater benefits than COMB for fatigue during surgery and chemotherapy.
- RE and COMB both improved physical function, with RE showing superiority in patients receiving hormone therapy.
- While not significant in main analyses, sensitivity analyses indicated RE favored lean mass and muscle strength over COMB, particularly after excluding outliers.
Conclusions:
- Personalized exercise medicine tailored to treatment characteristics is vital for women with breast cancer.
- Prescribing RE alone may be preferable to COMB to minimize potential interference effects on lean mass and muscle strength, especially during adjuvant and hormonal therapies.
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