Effect of exercise interventions on cognitive function in breast cancer patients and survivors: a systematic review with meta-analysis

Background: Exercise has been shown to facilitate cognitive function; however, data on changes in cognitive function in response to exercise interventions among breast cancer patients and survivors, who frequently experience cognitive impairment, have not been comprehensively synthesized. Therefore, this study aims to examine the impact of exercise interventions on cognitive function among breast cancer patients and survivors. Methods: Electronic databases including PubMed, Scopus, and Web of Science were searched from inception to December 25, 2024. A three-level meta-analysis was performed in R utilizing the standard mean difference. Moderators including cognitive function domains, sample characteristics (i.e., age and timing of exercise), and exercise regimen (i.e., frequency, intensity, type, session time, and length) were examined for subgroup analysis. The methodological quality and the certainty of evidence were evaluated using criteria of the Physiotherapy Evidence Database (PEDro) scale and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. Results: A total of 21 identified studies comprising 114 effect sizes were included in the final analysis. Overall, exercise demonstrated a positive small effect size on cognitive function in breast cancer patients and survivors (g = 0.22; 95% confidence interval [CI] 0.07–0.36; p <.001). Conclusions: Exercise demonstrated a facilitative effect on various cognitive functions among breast cancer patients during both treatment and survivorship. The non-significant moderation effects further suggest that diverse exercise regimens offer cognitive benefits. However, limited research highlights the need to identify optimal exercise modalities for cognitive enhancement in this population.