Dance-Based Exercise for Cancer-Related Fatigue in Breast Cancer Patients

Cancer‐related fatigue is one of the most prevalent and burdensome symptoms experiencedby patients with breast cancer during systemic anticancer treatment. Unlike ordinarytiredness, cancer‐related fatigue may persist despite rest and can negatively affectphysical functioning, psychological well‐being, daily activities, and quality of life.Exercise has been recognized as an important supportive strategy for the management ofcancer‐related fatigue; however, adherence to conventional exercise programs duringintensive cancer treatment may be challenging.Dance‐based exercise represents a multimodal form of physical activity combining aerobicexercise, coordination, balance, rhythmic movement, and social and cognitive engagement.Its enjoyable and adaptable nature may provide an alternative approach to maintainingphysical activity during cancer treatment. Nevertheless, evidence regarding the effectsof structured dance‐based exercise during neoadjuvant treatment for breast cancer remainslimited.This randomized controlled study will investigate the effects of a structured dance‐basedexercise intervention in women with breast cancer undergoing neoadjuvant treatment. Thestudy is designed to determine whether incorporating supervised dance‐based exercise intothe period of neoadjuvant treatment can reduce cancer‐related fatigue and supportphysical and psychosocial functioning compared with standard oncological care alone.The intervention is structured as a progressive, supervised dance‐based exercise programdelivered during neoadjuvant treatment. The program combines dance‐based aerobic activitywith movements targeting coordination, mobility, balance, and muscular function. Exerciseintensity and complexity will be individually adapted according to participants' physicalcondition, exercise tolerance, and treatment‐related symptoms. This approach is intendedto maintain an appropriate exercise stimulus while allowing flexibility in response tochanges in health status during oncological treatment.In addition to evaluating the clinical and functional effects of the intervention, thestudy includes an exploratory mechanistic component. Cancer treatment and physicalactivity may influence systemic metabolism, inflammatory processes, and the intestinalmicrobial ecosystem. The study will therefore investigate changes in the gut microbiomeand selected circulating biological markers and explore their relationships with changesin fatigue, physical fitness, body composition, physical activity, and other clinical andfunctional characteristics.The gut microbiome component will characterize microbial composition and diversity usingstool samples collected during the study. Blood‐based analyses will complement themicrobiome assessment by examining selected biological pathways potentially involved inthe response to exercise and cancer treatment. Integrating these biological data withfunctional and patient‐reported data may provide insight into mechanisms through whichexercise influences health and recovery during neoadjuvant breast cancer treatment.The longitudinal design will also allow the investigators to examine whether changesobserved during the intervention period are maintained during recovery following surgery.By combining a randomized exercise intervention with clinical, functional, behavioral,and biological assessments, the study aims to provide a comprehensive evaluation ofdance‐based exercise as a supportive strategy during neoadjuvant treatment for breastcancer.