Since 1978, exercise and sport therapy for oncological patients is a research and education focus at the German Sport University of Cologne. Back then, the top priority for almost all oncological patients was to “rest”. Therefore, uncharted territory was entered. Aside from acute care hospitals, rehabilitation hospitals especially for oncological patients exist in Germany. In terms of the rehabilitation chain, which consists of acute care hospital, rehabilitation center, and home-based training, and the aspect of exercise therapy for breast cancer patients, the following progress could be observed in the last 30 years: In the 1980s, less than 50 % of the breast cancer patients received supervised exercise therapy during their 2- to 3-week hospital stay. Today, the length of hospital stay was reduced to 4 to 6 days and some hospitals have gym equipment to increase strength and endurance. In the beginning of the 1980s, passive applications (physiotherapy, massages, bubble baths, short hikes) were still dominant. While the rehabilitation stay took 6 weeks back then, it was reduced to 3 weeks today. Further, mainly group-based and active measures are applied today. The aim is to encourage and motivate patients to long-term physical exercise. In the meantime, mainly exercise and sports therapists are employed, in order to meet the holistic bio-psychosocial requirements. The first cancer sports groups for breast cancer patients in the aftercare were founded in 1981 in Germany. Today, nearly 1,000 groups exist. Breast cancer and 15 other entities are represented, however mainly women take part. In the early days, research focused on the influence of physical activities on psychosocial aspects. Lately the effects on molecular, biological, and immunological parameters are also examined, in order to explore canceroprotective mechanisms.