654eP Prehabilitation during neoadjuvant therapy for breast cancer: Feasibility and early outcomes from a UK oncology centre

Abstract

Background: Structured exercise reduces postoperative morbidity in breast cancer and may improve survival. Recent trials of 'prehabilitation' (prehab) during neoadjuvant cancer therapy (NACT) demonstrate improved functional outcomes, high patient acceptability, and feasibility. However, real-world implementation of prehab in UK oncology services is limited. In 2024, Barts Health NHS Trust introduced a multimodal prehab programme for breast cancer patients on NACT. We report our early experience and descriptive outcomes from this service evaluation. Method(s): A multidisciplinary team of therapists delivered an individualised programme of aerobic exercise and resistance training, tailored to baseline fitness, comorbidities, and treatment-related symptoms. Physical health outcome measures were recorded at programme entry and completion. Clinical data were collected retrospectively. Result(s): 77 patients were referred, of whom 49 (64%) engaged with the programme. Participants had clinically staged T1-4 N0-2 M0 breast cancer. Participants were aged 25 to 73 (median age 48), and were of White (57%), Black (14%), Asian (14%), and Other or Mixed (14%) ethnicities. At baseline, median body mass index was 26.4 kg/m2 and 61% of participants had at least 1 comorbidity. Descriptive analyses of physical health outcome measures demonstrate functional capacity was maintained during NACT (see Table). 47 participants have now completed NACT; 41 (87%) finished all cycles, and 100% proceeded to surgery, with a median time to surgery of 5 weeks. A pathological complete response was seen in 23 participants (49%). [Formula presented] Conclusion(s): This evaluation demonstrates prehab was feasibly integrated into clinical care. Engagement was achieved in a diverse patient population. Importantly, functional capacity was preserved during NACT. These findings support future prospective evaluation of the impact of prehab within oncology pathways. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: P.E. Hall: Financial Interests, Personal, Other, Honorarium: Pfizer, Eisai, MSD, Seagen, Exact Sciences, Gilead, AstraZeneca, Lilly, Novartis, Stemline Menarini; Financial Interests, Personal, Advisory Board: Seagen, Daiichi Sankyo, Veracyte. V. Angelis: Financial Interests, Personal, Other, Travel grant: AstraZeneca, Novartis; Financial Interests, Personal, Invited Speaker: Novartis, Daiichi Sankyo. All other authors have declared no conflicts of interest. Copyright © 2026