Enhancing Cognitive Function in Breast Cancer Survivors Through Community-based Exercise Training

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) 3-36 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) 3-36 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 36 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