Table 1 Inclusion and exclusion criteria

• Women with primary breast cancer, stage I-III

• History of chronic disease (i.e., diabetes, uncontrolled hypertension, thyroid disease)

• ≥ 18 years of age

• Weight reduction > 10% within past 6 months

• Have undergone lumpectomy or mastectomy

• Metastatic disease

• Have completed neoadjuvant/adjuvant chemotherapy and/or radiation therapy

• Planned reconstructive surgery with flap repair during trial or follow-up period

• Initiate exercise program (if randomized to that arm) within 24 weeks of therapy completion

• Cardiovascular, respiratory, or musculoskeletal or joint problems that preclude moderate physical activity

• BMI ≥ 25 kg/m² or body fat > 30%

• Currently participates in < 60 minutes of physical activity per week

• May use adjuvant endocrine therapy if use will be continued for duration of study period

• Nonsmokers (No smoking during previous 12 months)

• Willing to travel to USC

Able to provide physician clearance to participate in exercise program

• Women of all racial and ethnic backgrounds will be included in the study enrollment process