Multimodal Exercise and Education Program in Metastatic Breast CancerMostrar más líneas

Women with metastatic breast cancer receiving active systemic treatment frequently experience impaired health-related quality of life, cancer-related fatigue, and limitations in daily functioning. Supportive care strategies that combine physical exercise, education, and symptom self-management may help improve these outcomes, although evidence in women living with metastatic breast cancer remains limited.

This study is a longitudinal pre-post intervention study conducted in women with metastatic breast cancer receiving active systemic treatment. Eligible participants are women with metastatic breast cancer, preserved functional status, and the ability to ambulate independently. Participants are assessed at baseline and after completion of the intervention.

The intervention lasts 12 weeks and consists of a community-based multimodal program combining supervised physical exercise and health education. The exercise component includes two 60-minute supervised sessions per week: one session of Nordic walking and one session of Tai Chi. Nordic walking sessions are supervised by a physiotherapist, and Tai Chi sessions are led by a trained instructor. Exercise sessions are adapted to participants' physical capacity and clinical condition.

In addition to the exercise component, participants attend structured health education workshops throughout the program. These sessions address topics relevant to women with metastatic breast cancer, including general aspects of metastatic breast cancer, systemic treatments and toxicity management, the benefits of physical exercise, nutrition and supplementation, sleep hygiene, emotional regulation, communication with the social environment, and aesthetic care during cancer treatment.

Health-related quality of life is assessed using the EORTC QLQ-C30 and the breast cancer-specific EORTC QLQ-BR45 questionnaires. Cancer-related fatigue is assessed using the EORTC QLQ-FA12 questionnaire. The study evaluates changes in global health status, functional domains, fatigue dimensions, and selected breast cancer-specific symptom and functional domains before and after the intervention.

The aim of the study is to determine whether a supervised, community-based multimodal program combining physical exercise and health education is associated with improvements in quality of life, functioning, and fatigue-related outcomes in women with metastatic breast cancer receiving active systemic treatment.

Inclusion criteria

• Women diagnosed with metastatic breast cancer.
• Receiving active systemic treatment.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
• Able to ambulate independently.
• Able and willing to participate in the multimodal intervention program.
• Provided written informed consent.

Exclusion criteria

• Moderate or severe cognitive impairment.
• Severe psychiatric illness.
• Sensory impairment preventing participation in the intervention or assessments.
• Chronic disabling conditions limiting participation in the planned activities.
• Unstable bone metastases, according to medical judgment, associated with risk of fragility fracture.
• Cardiac or respiratory disease limiting the capacity to perform physical activity.
• Any other medical condition that, in the opinion of the treating oncologist, contraindicated participation in the program.