Adherence to exercise in breast cancer survivors during and after active treatment: A systematic review and meta-analysis

Background Ensuring adherence to exercise programs is important for optimizing benefits and efficacy of interventions in women with breast cancer. Despite numerous studies on adherence to exercise in women with breast cancer, no systematic review has exclusively examined exercise adherence and its influencers during and after active treatment in this population. This review aims to examine the adherence rates and influencing factors for exercise in breast cancer survivors during and after treatment. Methods We systematically searched PubMed, CINAHL, Web of Science, and Scopus. We included studies on adherence to exercise and potential influencing factors conducted on women with breast cancer. Relevant studies were screened, and data were extracted. Analyses of adherence and factors influencing adherence were performed for ‘during’ and ‘after’ primary cancer treatment. Systematic review and meta-analyses were performed. Results Twenty-six studies were included. The overall pooled exercise adherence was 64% (95% CI: 58%–70%). Adherence to exercise during primary cancer treatment was 63% (95% CI: 55%–70%), and after primary cancer treatment was 68% (95% CI: 59%–78%), with no significant variation (Q ​= ​0.82, p ​= ​0.36). Physical fitness, baseline physical activity, fatigue, education, body mass index, and having a partner were identified to influence adherence during primary cancer treatments. Body mass index was reported to have a negative association with exercise adherence during and after primary cancer treatment. Conclusions The review revealed no significant variations in exercise adherence among women with breast cancer both during and after primary cancer treatments. Body mass index appeared to be negatively associated with both stages of primary cancer treatment.