Cognitive Impairment in Breast Cancer Survivors: The Protective Role of Physical Activity, Cardiorespiratory Fitness, and Exercise Training

An increasing population of breast cancer patients and survivors is living with treatment-related side effects including cancer-related cognitive impairment (CRCI). Neuropsychological and neuroimaging studies suggest changes in cognitive function and brain structure and function during and after treatment. CRCI has proven difficult to treat due to a lack of understanding of the precise underlying mechanisms and lack of consensus on the appropriate assessments to diagnose the presence and severity of cognitive dysfunction. Using the aging literature as a model, physical activity, cardiorespiratory fitness, and exercise training may protect against CRCI or restore declines in cognitive function. Preliminary studies with breast cancer survivors suggest physical activity interventions may improve cognitive function. Standardized objective assessments and normative values for the measurement of CRCI and physical activity-related factors are needed. The relationship between physical activity, exercise training, cardiorespiratory fitness, and CRCI needs to be further investigated to explore the potential for therapeutic improvement.