Background. Breast cancer (BC) remains a leading cause of morbidity and mortality among women worldwide. Therefore, the development of effective treatment and rehabilitation strategies for BC is of paramount importance. In recent decades, evidence has accumulated regarding the positive impact of physical activity on reducing the risk of BC development and progression. Objective. To analyze the influence of physical exercise on factors determining tumor growth and development, with the aim of identifying prospects for their application in the comprehensive treatment of BC. Materials and Methods. A systematic search of scientific publications was conducted in the electronic databases PubMed, Scopus, Web of Science, Google Scholar, and eLibrary.ru over the past 10 years. A total of 51 sources were selected, including 14 (28%) systematic reviews, 5 (10%) systematic reviews with meta-analysis, 1 - Clinical Practice Guideline (ASCO), and 18 RCTs (36%). The selection criteria included publications in Russian or English, systematic reviews and meta-analyses, and original research articles dedicated to studying the influence of physical exercise on the tumor microenvironment, antitumor immunity, and the vascular network of BC. Results. The literature analysis demonstrated that physical exercise exerts a multifaceted effect on BC progression, comprehensively regulating immune function, suppressing the growth of primary breast tumors, normalizing the vascular network, and improving the metabolic state of the tumor. Physical activity contributes to a reduction in the levels of pro-inflammatory cytokines, enhancement of antitumor immunity, normalization of the tumor vascular network, and increased effectiveness of chemotherapy. Conclusion. Physical activity represents a valuable component of a comprehensive approach to BC treatment, exerting a positive influence on clinical outcomes and survival. Further research is needed to determine the optimal dose and regimens of physical exercise, as well as for the personalization of rehabilitation approaches. Coordination of efforts by a multidisciplinary team is crucial for optimizing the results of BC treatment using physical exercise.