Objective:

To evaluate the effectiveness of different exercise modalities on quality of life (QoL) in breast cancer survivors post-treatment, addressing the lack of modality-specific evidence in current guidelines.

Key Findings:

• Sixty-nine RCTs involving 5,294 breast cancer survivors were included, with all exercise modalities except high-intensity interval training and Pilates significantly improving QoL compared to usual care, which serves as a baseline for comparison.
• Combined exercise was identified as the most effective modality (SMD = 1.40), followed by Tai Chi, aerobic exercise, Qigong, yoga, and resistance training.

Interpretation:

Combined exercise integrating aerobic and resistance components offers the greatest improvement in QoL among breast cancer survivors, supporting personalized exercise prescriptions in survivorship care and highlighting the need for tailored interventions.

Limitations:

• The study may not account for individual variations in response to different exercise modalities, which could affect the generalizability of the findings.
• High-intensity interval training and Pilates were not found to be effective, which may require further investigation to understand the underlying reasons.

Conclusion:

The findings provide modality-specific evidence for exercise interventions, emphasizing the importance of tailored exercise programs to enhance QoL in breast cancer survivors and informing future clinical guidelines.