BackgroundPhysical activity (PA) can play a role in lowering the risk of breast cancer (BC), but also in reducing treatments related side effects, improving the quality of life and decreasing mortality in BC survivors. Despite these benefits, the majority of BC patients do not achieve the recommended levels of PA and often reduce their exercise frequency after the diagnosis. Moreover, PA screening and counseling are not offered to patients as standard of care, even in high quality breast units. MethodsFrom February 2019 to March 2020, we performed a preoperative physical and nutritional screening in 504 consecutive BC patients waiting for surgery. The screening included an IPAQ questionnaire to evaluate the level of physical activity, measurement of anthropometric parameters (weight, height, waist and hips circumference, BMI and Waist Hips Ratio) and evaluation of body composition using Bioelectrical Impedance Analysis (BIA). ResultsThe majority of patients in our series resulted physically inactive: clustering the IPAQ scores, 47% of patients proved to be physically inactive (MET score 2520). In addition, approximately half of the patients (49%) resulted overweight or obese, and more than half (55%) had a percentage of fatty tissue over the recommended cut off for adult women. ConclusionsOur data confirm that assessment of PA levels should become part of the standard preoperative evaluation of BC patients and behavioral interventions should be offered to them, in order to prehabilitate to surgery and improve outcomes.