A systematic review and meta-analysis of randomized controlled trials on the effects of high-intensity interval training in breast cancer survivors

Abstract

Objective

Exercise is a well-recognized, safe, and effective strategy for breast cancer survivors. This study aimed to evaluate the effects of high-intensity interval training on multiple clinical outcomes in this population.

Data sources

We conducted a search of the PubMed, EMBASE, and Cochrane Library databases from their inception through June 30, 2025, and updated on September 6, 2025.

Review Methods

This systematic review and meta-analysis included randomized controlled trials that compared high-intensity interval training with usual care, moderate-intensity continuous training, or resistance training for breast cancer survivors on multiple clinical outcomes.

Results

Fifteen trials were included. High-intensity interval training significantly improved cardiorespiratory fitness compared to usual care, moderate-intensity continuous training, and resistance training. It was also superior to usual care for improving quality of life and reducing high-sensitivity C-reactive protein, and superior to moderate-intensity continuous training for reducing Interleukin-6. However, according to the GRADE assessment, the certainty of evidence for these outcomes was low, primarily due to the risk of bias and imprecision from small sample sizes. No major exercise-related adverse events were reported. A framework (Frequency, Intensity, Time, and Type) typically recommends three 30­–40-minute sessions per week for a duration of 8–12 weeks, with adaptable protocols featuring various interval structures and exercise types.

Conclusions

High-intensity interval training is a safe and effective modality for breast cancer survivors, demonstrating superior improvements in cardiorespiratory fitness over various control interventions. Its benefits for quality of life and inflammation support its use in clinical rehabilitation.