Leach, H.J., Danyluk, J.M., Nishimura, K.C., & Culos-Reed, S.N. (2016). Benefits of 24 versus 12 weeks of exercise and wellness programming for women undergoing treatment for breast cancer. Supportive Care in Cancer, 24, 4597–4606. 

DOI Link

Study Purpose

To compare the physiological and psychosocial outcomes of a community exercise program at 12 versus 24 weeks for patients with breast cancer who were currently undergoing or were within three months of completing chemotherapy and radiation treatment and therefore still experiencing many acute treatment-related side effects

Intervention Characteristics/Basic Study Process

The Engaging in Activity While Undergoing Treatment (BEAUTY) program is a 12-week exercise program for patients with breast cancer with an optional 12-week maintenance component. It aims to (a) use exercise and education to restore and maintain the physical well-being of women living with breast cancer while on treatment, (b) increase awareness of the importance of healthy lifestyle behaviors, and (c) provide practical tools and a variety of resources to empower women to actively take charge of their health, fitness, and well-being. BEAUTY participants receive individualized fitness assessments at baseline, 12 weeks, and 24 weeks; personalized exercise plans; twice weekly group-based exercise classes; and biweekly education classes. A full description of the BEAUTY program methodology has been previously reported.

Sample Characteristics

  • N = 121   
  • AGE = 50.5 years (SD = 8.7 years)
  • FEMALES: 100%
  • CURRENT TREATMENT: Chemotherapy, radiation, combination radiation and chemotherapy
  • OTHER KEY SAMPLE CHARACTERISTICS: All participants were diagnosed with breast cancer and were currently undergoing or were within three months of completing chemotherapy.


  • SITE: Single site   
  • SETTING TYPE: Other    
  • LOCATION: Community program operates within the Health and Wellness Lab at the University of Calgary in Alberta, Canada

Phase of Care and Clinical Applications

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Elder care

Study Design

Pre-post design

Measurement Instruments/Methods

  • Physical health outcomes
  • Health-related quality of life, fatigue, cognitive function, and depressive symptoms
  • The physical well-being (PWB) subscale score
  • Functional Assessment of Cancer Therapy-Breast (FACT-B) total score
  • The FACT-B Breast Cancer Subscale (BCS) score
  • FACT-General (FACT-G)
  • The FACT-G physical well-being (PWB) subscale score
  • The FACT-G emotional well-being (EWB) subscale score
  • Center for Epidemiological Studies Depression Scale (CESD)
  • FACT-Cognitive Function (FACT-Cog)


  • Body mass index increased from baseline to 12 weeks by 0.5 kg/m2 (p = 0.01). No significant differences were reported in participant-reported quality of life, fatigue, cognitive function, or depressive symptoms from baseline to 12 weeks.
  • For the 24-week intervention, many of the physical health outcome measures improved significantly.
  • The FACT-B total score at 24 weeks improved by 7.4 points compared to both (p = 0.002).
  • The FACT-G score at 24 weeks improved by 5.9 and 5.6, respectively, compared to baseline (p = 0.003) and 12 weeks (p = 0.001). The FACT-B Breast Cancer Subscale (BCS) score at 24 weeks improved by 1.4 (p > 0.05) compared to baseline and by 1.8 compared to 12 weeks (p = 0.038).
  • The physical well-being (PWB) subscale score at 24 weeks improved by 1.8 and 2.8 compared to baseline (p = 0.015) and 12 weeks (p = 0.002), respectively. The emotional well-being (EWB) subscale score at 24 weeks improved by 1.6 compared to baseline (p = 0.029) and by 0.7 compared to 12 weeks (p > 0.05). The functional well-being (FWB) subscale score at 24 weeks improved by 2.1 and 1.7 compared to baseline (p = 0.017) and 12 weeks (p = 0.01), respectively. No significant differences in social well-being (SWB) subscale scores existed at 24 weeks. Participant-reported fatigue measured by the Functional Assessment of Chronic Illness-Fatigue (FACIT-F) questionnaire improved 5.1 at 24 weeks compared to 12 weeks (p = 0.002).
  • No significant differences in cognitive function measured by the FACT-Cog were reported. 
  • Depressive symptoms measured by the CESD improved (decreased) at 24 weeks by 2.8 and 2.9 compared to baseline (p = 0.05) and 12 weeks (p = 0.009), respectively.


The findings from this study suggest that a 24-week exercise program is effective in improving aerobic fitness, waist to hip ratio, quality of life, fatigue, and depressive symptoms in patients with breast cancer undergoing or within three months of completing chemotherapy and/or radiation treatment, whereas findings after 12 weeks showed maintenance of most physiological and psychosocial outcomes but no statistical or clinical improvement. Longer duration (i.e., greater than three months) exercise programs during treatment and/or a continuation of programs following treatment in breast cancer survivors may be indicated to see improvement beyond preventing declines or maintenance of fitness, fatigue, and quality of life.


  • Risk of bias (no random assignment) 
  • Risk of bias (no appropriate attentional control condition)
  • Risk of bias (sample characteristics)

Nursing Implications

The findings can be applied to community exercise and rehabilitation programs for breast cancer survivors. Nurses should advise their patients to exercise longer.