Exercise training intensity prescription in breast cancer survivors: validity of current practice and specific recommendations



Cancer survivors are recommended to perform 150 min/week of moderate or 75 min/week of vigorous aerobic exercise, but it remains unclear how moderate and vigorous intensities can be prescribed. Therefore, it was investigated whether and how intensity prescriptions for healthy adults by the American College of Sports Medicine (ACSM) need to be adapted for breast cancer survivors.


Fifty-two breast cancer survivors (stage 0–III, age 52 ± 9 years, BMI 25.4 ± 3.5 kg/m2) performed cardiopulmonary exercise tests at the end of primary therapy. Intensity classes defined as percentages of maximal heart rate (HRmax), heart rate reserve (HRR), and maximal oxygen uptake (VO2max) were compared to the ACSM’s intensity classes using oxygen uptake reserve as reference.


The prescriptions for moderate and vigorous exercise intensities were significantly different between breast cancer survivors and healthy adults when using VO2max (moderate 50–66 vs. 46–63 and vigorous 67–91 vs. 64–90 % VO2max) or HRR (moderate 26–50 vs. 40–59 and vigorous 51–88 vs. 60–89 % HRR), but not when using HRmax (moderate 65–76 vs. 64–76 and vigorous 77–94 vs. 77–95 % HRmax).


In breast cancer survivors, intensity prescriptions for healthy adults result in considerably too intense training if HRR is used as guiding factor. Prescriptions using VO2max result in a slightly too low exercise intensity, whereas recommendations in percentages of HRmax appear valid.

Implications for Cancer Survivors

Cancer survivors should not uncritically adopt exercise intensity prescriptions for healthy adults. Specific prescriptions for the studied population are provided.

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Acknowledgments and Funding Information

The BEST study was funded by the Interdisciplinary Research Funding Program (intramural) of the National Center for Tumor Diseases (NCT) Heidelberg and supported by the Foundation “Stiftung Leben mit Krebs.” Dr. Wiskemann was personally supported by the Manfred-Lautenschlaeger-Foundation.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Correspondence to Friederike Scharhag-Rosenberger.

Additional information

Karen Steindorf and Joachim Wiskemann shared last authorship.

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Scharhag-Rosenberger, F., Kuehl, R., Klassen, O. et al. Exercise training intensity prescription in breast cancer survivors: validity of current practice and specific recommendations. J Cancer Surviv 9, 612–619 (2015) doi:10.1007/s11764-015-0437-z

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  • Cancer patients
  • Supportive therapy
  • Physical activity
  • Endurance training
  • Aerobic training
  • Aerobic exercise