Journal article
Exercise effects on lean body mass, muscle strength and functional performance in patients with metastatic breast cancer: the randomized controlled PREFERABLE-EFFECT study
Breast Cancer Research, Vol.28, pp.1-13
2026
PMCID: PMC13188511
PMID: 41975453
Appears in Cancer Research Cluster Research Collection
Abstract
Background
Low skeletal muscle mass and strength are common in patients with metastatic breast cancer (mBC) and have been associated with treatment toxicities and poor prognosis. The PREFERABLE-EFFECT study (NCT04120298) investigated exercise effects on body composition, muscle strength, and functional performance (secondary outcomes) in patients with mBC.
Methods
Patients with mBC (n = 357) were randomized to a 9-month supervised aerobic, resistance and balance exercise program (EX) or control. Body composition (subset n = 66), lower body strength (subset n = 126), handgrip strength and functional performance were assessed at baseline, 3 and 6 months. Changes between groups were compared using linear mixed models for repeated measures.
Results
EX significantly increased whole body lean mass at 3 months (between-group difference = 0.79 kg, 95%CI [0.14; 1.44], effect size = 0.14), appendicular skeletal muscle mass at 3 months (0.60 kg, [0.22; 0.97], ES = 0.19) and 6 months (0.48kg, [0.09; 0.87], ES = 0.15), and lower body strength at 3 months (18.32 kg, [7.58; 29.06], ES = 0.44) and 6 months (34.22 kg, [23.0; 45.45], ES = 0.83) compared to control. EX also improved functional performance, including balance, compared to control.
Conclusions
The results support the promotion of supervised exercise for patients with mBC, with beneficial effects on skeletal muscle mass, muscle strength and physical performance.
Trial registration
The PREFERABLE-EFFECT study was registered on ClinicalTrials.gov on October 9, 2019 (NCT04120298).
Details
- Title
- Exercise effects on lean body mass, muscle strength and functional performance in patients with metastatic breast cancer: the randomized controlled PREFERABLE-EFFECT study
- Authors
- Eva M Zopf (Corresponding Author) - Cabrini HospitalGustav Joernaker - Karolinska University HospitalDorothea Clauss - German Sport University CologneMark Trevaskis - Australian Catholic UniversityAnouk E Hiensch - Utrecht UniversityMartina E Schmidt - German Cancer Research CenterEvelyn M Monninkhof - Utrecht UniversityPhilipp Zimmer - TU Dortmund UniversityJon Belloso - OsakidetzaElisa Heyrman - Karolinska University HospitalRodrigo Fernandez Gonzalo - Karolinska University HospitalJoachim Wiskemann - Heidelberg UniversityJana Müller - Heidelberg UniversityKate A Bolam - University of the Sunshine CoastMaciej Gorecki - Greater Poland Cancer CenterRenske Altena - Karolinska InstitutetChristine Muttiah - Cabrini HospitalElsken van der Wall - Utrecht UniversityNeil K Aaronson - The Netherlands Cancer InstituteElzbieta Senkus - University Clinical CentreAnder Urruticoechea - OsakidetzaMartijn M Stuiver - The Netherlands Cancer InstituteKaren Steindorf - German Cancer Research CenterWilhelm Bloch - German Sport University CologneYvonne Wengström - Karolinska University HospitalAnne M May - Utrecht UniversityHelene Rundqvist - Karolinska University Hospital
- Publication details
- Breast Cancer Research, Vol.28, pp.1-13
- Publisher
- BioMed Central Ltd.
- Date published
- 2026
- DOI
- 10.1186/s13058-026-02235-6
- ISSN
- 1465-542X
- PMID
- 41975453; PMC13188511
- Copyright note
- This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
- Data Availability
- The data that support the findings of this study are not yet openly available owing to reasons of confidentiality. Researchers can request current data from the principal investigator of the PREFERABLE-EFFECT study (a.m.may@umcutrecht.nl).
- Grant note
- (No 825677) / European Union's Horizon 2020 research and innovation program.
- Organisation Unit
- Cancer Research Cluster
- Language
- English
- Record Identifier
- 991229282702621
- Output Type
- Journal article
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