TY - JOUR
T1 - Comparison of the effects of low- versus High-Supervision exercise on breast cancer survivorship outcomes
AU - Bloomquist, Kira
AU - Spence, Rosalind R
AU - Vagenas, Dimitrios
AU - Pyke, Christopher
AU - Sandler, Carolina X
AU - Rye, Sheree
AU - Young, Leonie
AU - Hayes, Sandra C
N1 - © The Author(s) 2026. Published by Oxford University Press.
PY - 2026/1/25
Y1 - 2026/1/25
N2 - BACKGROUND: Supervised exercise may provide greater functional and quality of life benefits than unsupervised programs after cancer and is recommended for those with or at risk of breast cancer-related lymphedema. These exploratory analyses compared the effect of low- versus high-supervision exercise on the secondary, survivorship outcomes of the SAFE breast cancer trial.METHODS: This randomized study (ANZCTR: ACTRN12616000547448) compared a 12-week, exercise program (target 150 minutes/week, moderate-intensity) supported by either five (LOW) or 20 (HIGH) supervised sessions. Inclusion criteria included: stage ll+ breast cancer within five years, ≥ one comorbidity and/or treatment-related adverse effect and insufficiently active. Outcomes included lymphedema (self-report and bioimpedance spectroscopy), arm symptoms, upper-extremity function (PROMIS Bank v1.2-Upper- Extremity), fatigue, pain, pain interference, pain intensity, physical function, sleep disturbance, anxiety, depression, and satisfaction with social roles (PROMIS-43 Profile v1.0). Chi-square tests evaluated between-group symptom changes. Generalized estimating equations assessed time, group, and time×group effects under an intention-to-treat, two-sided framework.RESULTS: Sixty women (mean age, 50 years) were randomized to LOW (n = 30) versus HIGH (n = 30). At follow-up, both groups showed similar lymphedema prevalence, comparable rates of maintained or improved arm symptoms, and within-group improvements (p < .05) in fatigue, physical function, sleep, anxiety, depression, and satisfaction with social roles and activities. Potential for superior benefit in HIGH versus LOW was observed for self-reported range of movement, upper-extremity function, and pain interference and intensity (p < .05).CONCLUSION: Findings indicate that breast cancer survivors with or at risk of lymphedema can benefit from exercise, even when supervision is limited.
AB - BACKGROUND: Supervised exercise may provide greater functional and quality of life benefits than unsupervised programs after cancer and is recommended for those with or at risk of breast cancer-related lymphedema. These exploratory analyses compared the effect of low- versus high-supervision exercise on the secondary, survivorship outcomes of the SAFE breast cancer trial.METHODS: This randomized study (ANZCTR: ACTRN12616000547448) compared a 12-week, exercise program (target 150 minutes/week, moderate-intensity) supported by either five (LOW) or 20 (HIGH) supervised sessions. Inclusion criteria included: stage ll+ breast cancer within five years, ≥ one comorbidity and/or treatment-related adverse effect and insufficiently active. Outcomes included lymphedema (self-report and bioimpedance spectroscopy), arm symptoms, upper-extremity function (PROMIS Bank v1.2-Upper- Extremity), fatigue, pain, pain interference, pain intensity, physical function, sleep disturbance, anxiety, depression, and satisfaction with social roles (PROMIS-43 Profile v1.0). Chi-square tests evaluated between-group symptom changes. Generalized estimating equations assessed time, group, and time×group effects under an intention-to-treat, two-sided framework.RESULTS: Sixty women (mean age, 50 years) were randomized to LOW (n = 30) versus HIGH (n = 30). At follow-up, both groups showed similar lymphedema prevalence, comparable rates of maintained or improved arm symptoms, and within-group improvements (p < .05) in fatigue, physical function, sleep, anxiety, depression, and satisfaction with social roles and activities. Potential for superior benefit in HIGH versus LOW was observed for self-reported range of movement, upper-extremity function, and pain interference and intensity (p < .05).CONCLUSION: Findings indicate that breast cancer survivors with or at risk of lymphedema can benefit from exercise, even when supervision is limited.
U2 - 10.1093/jncics/pkag004
DO - 10.1093/jncics/pkag004
M3 - Journal article
C2 - 41581141
SN - 2515-5091
JO - JNCI Cancer Spectrum
JF - JNCI Cancer Spectrum
M1 - pkag004
ER -