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Surgery remains the cornerstone of breast cancer treatment. However, up to one in three women experience postoperative complications, including infection, bleeding, pain or functional impairment following breast surgery, with both the risk and type of complications varying according to surgical complexity. 1 These adverse events may delay adjuvant therapy, prolong hospital stay and compromise recovery.2–4 Despite remarkable advances in surgical techniques and perioperative care, the risk of postoperative morbidity remains considerable.1 In recent years, exercise-based prehabilitation (ie, structured physical conditioning before surgery) has emerged as a promising strategy to enhance cardiorespiratory fitness and accelerate recovery in various cancer populations.4 Yet, its potential to prevent postoperative complications in women with breast cancer remains largely unexplored. This represents a critical gap in the continuum of cancer care: if exercise could not only support recovery but also prevent complications before they arise, it might have important implications for perioperative oncology practices and patient outcomes. Therefore, the present Editorial aims to underscore a critical gap in breast cancer care by examining whether exercise-based prehabilitation can move beyond enhancing recovery to actively preventing postoperative complications.