Integrating physical exercise into breast cancer care: implications for tumor development

Physical exercise is well recognized for its role in improving quality of life and outcomes in breast cancer management. Beyond these well-established benefits, exercise has the potential to modulate tumor growth and proliferation, thereby enhancing the efficacy of anticancer therapies. Physical exercise targets several key factors in cancer progression including tumor cell proliferation, immune cells infiltration, tumor microenvironment dynamics, and tumor metabolism, ultimately leading to reduced tumor growth. Aerobic exercise, for example, has been reported to promote immune cell mobilization, particularly by increasing NK cell infiltration in tumors. While the anticancer effects of resistance exercise are less studied, emerging evidence suggests it plays a key role in the muscle-tumor crosstalk, largely driven by myokine secretion. Both types of exercise influence inflammatory pathways and endocrine regulation, particularly by modulating ERα/ERβ ratio and estrogen biosynthesis. This article delves into the molecular mechanisms underlying the role of physical exercise as a potential adjunctive therapy in BCa management, offering insights that could guide future research and clinical applications.