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This study tested whether a 12-month exercise intervention improved cognition in breast cancer survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Breast cancer survivors (n\u2009=\u2009253) were randomized to an exercise arm with a remotely delivered intervention or a Health &amp; Wellness arm receiving calls on healthy aging topics at the same frequency. The 6-month intervention (primary end-point) was followed by a 6-month maintenance phase (secondary end-point). At baseline, 3, 6, and 12 months, participants wore an accelerometer and completed the PROMIS Cognitive Abilities Questionnaire, the NIH Toolbox Digit symbol test (Processing Speed), and a neurocognitive battery assessing memory, executive function, and attention. Linear mixed models compared outcomes between arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Exercise arm had greater increases in moderate to vigorous physical activity (18\u2009minutes\/day baseline, 23.5\u2009minutes\/day 12\u2009months) than the Health &amp; Wellness arm (15\u2009minutes\/day baseline, 15.5\u2009minutes\/day 12\u2009months) at all follow-ups (P-values\u2009&amp;lt;\u2009.01). No significant between-group effects were observed for primary outcomes of self-reported cognition or processing speed at 6 or 12 months (P-values\u2009&amp;gt;\u2009.05). However, for secondary outcomes, the Exercise arm had greater improvements than the Health &amp; Wellness arm in attention (6 months: b\u2009=\u20090.14, P\u2009=\u20090.03; 12 months: b\u2009=\u20090.21, P=.002), and memory (6 months: b\u2009=\u20090.18, P\u2009&amp;lt;\u2009.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A remotely delivered Exercise intervention was not superior to a Health &amp; Wellness intervention for self-reported cognition or processing speed. However, secondary outcomes suggest sustained improvements in attention and short-term benefits in memory. Exercise warrants further investigation as a strategy to support cognitive health in breast cancer survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT04049695<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag295","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:50:26Z","timestamp":1789041026000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of an exercise intervention on cognition in breast cancer survivors: a randomized controlled trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3719-0624","authenticated-orcid":false,"given":"Sheri J","family":"Hartman","sequence":"first","affiliation":[{"name":"Herbert Wertheim School of Public Health, UC San Diego , La Jolla, CA,","place":["United States"]},{"name":"UC San Diego 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