Precision Rehabilitation In Breast Cancer Survivorship: Integrating Personalized Physiotherapy Strategies In The Era Of Targeted Oncology

Advances in targeted therapies, immunotherapy, and multimodal cancer treatments have substantially improved survival rates across multiple malignancies.However, the growing population of cancer survivors continues to experience significant treatment-related toxicities, including cancer-related fatigue, chemotherapy-induced peripheral neuropathy, sarcopenia, cardiotoxicity, lymphedema, and cognitive impairment.These complications often lead to persistent functional limitations, reduced quality of life, and increased healthcare burden.While exercise oncology has demonstrated consistent benefits in mitigating many of these adverse effects, conventional rehabilitation models frequently adopt generalized exercise prescriptions that may not adequately address individual variability in treatment response, biological profile, and symptom burden.Precision cancer rehabilitation has emerged as an evolving paradigm that integrates personalized physiotherapy strategies tailored to patient-specific clinical characteristics, treatment modalities, functional status, and toxicity profiles.This narrative review synthesizes contemporary evidence from peer-reviewed literature indexed in Scopus and PubMed to examine the role of individualized physiotherapy in managing treatment-related toxicities across the cancer continuum, including prehabilitation, active treatment, and survivorship phases.Emphasis is placed on toxicity-stratified exercise prescription, biomarkerinformed rehabilitation approaches, integration of digital health technologies, and multidisciplinary coordination within modern oncology care.Current evidence supports aerobic and resistance training as safe and effective interventions for improving physical function, reducing fatigue, attenuating muscle wasting, enhancing cardiopulmonary capacity, and improving psychosocial outcomes in cancer populations.Emerging data suggest that personalized, symptommodulated, and technology-assisted rehabilitation models may further optimize outcomes compared to standard exercise recommendations.Precision cancer rehabilitation represents a necessary progression in exercise oncology, aligning physiotherapy interventions with the biological and clinical complexity of contemporary cancer care.Future research should prioritize biomarker-guided exercise dosing, long-term functional outcomes, and randomized trials comparing personalized versus conventional rehabilitation models to strengthen the evidence base for precision-based survivorship care.