Objective This study aimed to explore the efficacy of different exercise therapies in reducing fatigue in patients with breast cancer. Design PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, China Biology Medicine, China National Knowledge Infrastructure, Database of Chinese Sci-tech Periodicals, and Wanfang databases were searched from their inception to March 2022. The authors independently screened all randomized controlled trials of exercise therapy in patients with breast cancer. A network meta-analysis was performed using Stata 16.0 software. Results Seventy-eight studies were analyzed, with 167 comparisons and 6235 patients. The network results showed that stretching (standardized mean difference = −0.74, confidence interval = −1.43 to −0.06), yoga (standardized mean difference = −0.49, confidence interval = −0.75 to −0.22), combined exercise (standardized mean difference = −0.47, confidence interval = −0.70 to −0.24), aerobic exercise (standardized mean difference = −0.46, confidence interval = −0.66 to −0.26), and resistance exercise (standardized mean difference = −0.42, confidence interval = −0.77 to −0.08) significantly reduced fatigue. Pairwise comparisons confirmed that yoga, combined exercise, aerobic exercise, and resistance exercise were positively associated with fatigue relief. However, no significant association was identified between reduced fatigue and traditional Chinese exercises or stretching. Conclusions The most effective exercise therapy to relieve cancer-related fatigue in patients with breast cancer was yoga, followed by combined aerobic and resistance exercises. It is expected that more randomized controlled trials will be conducted to further explore the efficacy and mechanisms of exercise.

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