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A key driver of tumor progression and resistance to therapy is abnormal vascularization, which leads to heterogeneous blood flow, hypoxia, impaired drug delivery, and increased malignancy. Emerging clinical evidence suggests that breast tumor Doppler ultrasound parameters can predict pathological response to neoadjuvant chemotherapy, highlighting the potential of tumor blood flow as a prognostic biomarker. In this context, strategies to modulate tumor perfusion\u2014particularly through non-pharmacological approaches\u2014are of growing interest. Exercise has shown promise in promoting vascular remodeling, improving oxygenation, and enhancing treatment efficacy. This narrative review discusses current evidence on the role of tumor blood flow in disease progression and therapeutic response, with special emphasis on the modulatory effects of exercise training. We also explore how tumor blood flow is assessed, briefly outlining key methodologies such as Doppler ultrasound, contrast-enhanced imaging, and perfusion-related biomarkers, and their relevance for interpreting exercise-induced vascular adaptations, its association with tumor aggressiveness, and the interplay between exercise and oncological therapies. Understanding how exercise influences tumor hemodynamics may pave the way for innovative adjuvant strategies in breast cancer management.<\/jats:p>","DOI":"10.1007\/s40279-026-02392-w","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T13:15:01Z","timestamp":1769519701000},"page":"913-926","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Breast Tumor Blood Flow, Disease Progression, and Treatment Response: The Role of Exercise"],"prefix":"10.1007","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9164-6768","authenticated-orcid":false,"given":"Ol\u00edvia M.","family":"Ruberti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme D.","family":"Telles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie F. 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All data discussed are available in the published literature cited in the manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability statement"}},{"value":"Conceptualization: Miguel Soares Concei\u00e7ao and Olivia Moraes Ruberti. Literature search: Olivia Moraes Ruberti, Sophie Derchain, and Eva Zopf. Writing\u2014original draft preparation: Olivia Moraes Ruberti and Miguel Soares Concei\u00e7\u00e3o. Writing\u2014critically revised the work: Guilherme Defante Telles, Sophie Derchain, Rafaela Bertini Ara\u00fajo, Dhyana Lima, Henrique Bortolozo, Lu\u00eds Ot\u00e1vio Zanatta Sarian, Eva Zopf, and Rodrigo Menezes Jales. Supervision: Miguel Soares Concei\u00e7\u00e3o. All authors read and approved the final version.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}