Exercise intervention to improve cognitive function in breast cancer survivors

Inclusion Criteria

* PRE-REGISTRATION: Age ≥50 years at time of pre-registration visit according to participant report and/or clinical determination
* PRE-REGISTRATION: First, primary diagnosis of stage I-IIIa breast cancer according to participant report and/or clinical determination
* PRE-REGISTRATION: Post-surgery and completed primary treatment (i.e., surgery, chemotherapy, and/or radiation therapy) 3-60 months prior to registration according to participant report and/or clinical determination
* PRE-REGISTRATION: Sedentary except for casual lifestyle recreation defined as self-reporting no more than 90 minutes per week of moderate-intensity aerobic exercise within the last 6 months
* PRE-REGISTRATION: Self-reported ability to complete assessments by themselves or with assistance
* REGISTRATION: Age ≥50 years as confirmed via clinical determination
* REGISTRATION: Able to provide medical record release to confirm eligibility
* REGISTRATION: First, primary diagnosis of stage I-IIIa breast cancer as confirmed via clinical determination
* REGISTRATION: Post-surgery and completed primary treatment (i.e., surgery, chemotherapy, and/or radiation therapy) 3-60 months prior to pre-registration as confirmed via clinical determination
* REGISTRATION: No evidence of possible cognitive impairment as assessed using the Telephone Interview of Cognitive status (13-item modified version) (TICS-M; score \> 21) NOTE: Only individuals who pass the TICS-M during pre-registration will be invited to participate in the urine substudy
* REGISTRATION: Receive physician's clearance to participate in an exercise program

NOTE: Individuals with conditions/diagnoses deemed important by the primary investigator will be required to provide clearance for exercise from their cardiologist. Example conditions include:

* History of major multiple myocardial infarctions (MI)
* Recent electrocardiogram (ECG) changes or recent MI
* Resting or unstable angina
* Significant multivessel coronary occlusion (≥ 70%) on angiography
* Uncontrolled and/or serious arrhythmias
* 3rd degree heart block
* Acute congestive heart failure or ejection fraction \< 30%

  * REGISTRATION: Ability to complete assessments by themselves or with assistance

Exclusion Criteria:

* PRE-REGISTRATION: Stage 0 breast cancer diagnosis OR metastatic disease
* PRE-REGISTRATION: Currently receiving or \< 3 months since receiving chemotherapy or radiation therapy for cancer, or greater than 60 months post primary treatment
* PRE-REGISTRATION: Planned surgery during the intervention period
* PRE-REGISTRATION: Second cancer diagnosis (excluding non-invasive skin cancers or carcinoma-in-situ for any cancer)
* PRE-REGISTRATION: Unable to travel regularly to the study locations for intervention sessions and data collection
* PRE-REGISTRATION: Unwilling to return to enrolling institution for follow-up
* PRE-REGISTRATION: Self-reported inability to walk without assistance or devices
* REGISTRATION: History of stroke, transient ischemic attack, other neurological disorders, or brain surgery involving tissue removal as confirmed via clinical determination
* REGISTRATION: Clinically significant TICS-M score (\< 21) during baseline procedures
* REGISTRATION: Not able to provide physician re-clearance for exercise if required based upon clinically significant baseline exercise test (as determined by ECG and blood pressure monitoring)
* REGISTRATION: Contraindications to functional magnetic resonance imaging (fMRI) in accordance with the Mayo Clinic Department of Radiology safety protocols
* REGISTRATION: Clinically significant MRI scan as determined by physician review in which the following is advised via radiologist overread: remarkable/abnormal limited diagnostic brain image with recommended medical follow-up
* REGISTRATION: Enrolled in another physical activity program
* REGISTRATION: Unable to walk without assistance or devices
* REGISTRATION: Unwilling to complete study requirements
* REGISTRATION: Unwilling to be randomized to the exercise group or health education group
* REGISTRATION: Unable or unwilling to continuously wear and regularly sync/charge an activity tracker during the study period
* REGISTRATION: Unable to travel regularly to the study locations for intervention sessions and data collection
* REGISTRATION: Unwilling to return to enrolling institution for follow-up