Physical activity and survival after diagnosis of invasive breast cancer

Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.32). 02/2008; 17(2):379-86. DOI: 10.1158/1055-9965.EPI-07-0771
Source: PubMed

ABSTRACT Previous studies suggest that increased physical activity may lower the risk of breast cancer incidence, but less is known about whether levels of physical activity after breast cancer diagnosis can influence survival. We prospectively examined the relation between postdiagnosis recreational physical activity and risk of breast cancer death in women who had a previous invasive breast cancer diagnosed between 1988 and 2001 (at ages 20-79 years). All women completed a questionnaire on recent postdiagnosis physical activity and other lifestyle factors. Among 4,482 women without history of recurrence at the time of completing the questionnaire, 109 died from breast cancer within 6 years of enrollment. Physical activity was expressed as metabolic equivalent task-hours per week (MET-h/wk); hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated using Cox proportional hazards regression. After adjusting for age at diagnosis, stage of disease, state of residence, interval between diagnosis and physical activity assessment, body mass index, menopausal status, hormone therapy use, energy intake, education, family history of breast cancer, and treatment modality compared with women expending <2.8 MET-h/wk in physical activity, women who engaged in greater levels of activity had a significantly lower risk of dying from breast cancer (HR, 0.65; 95% CI, 0.39-1.08 for 2.8-7.9 MET-h/wk; HR, 0.59; 95% CI, 0.35-1.01 for 8.0-20.9 MET-h/wk; and HR, 0.51; 95% CI, 0.29-0.89 for > or =21.0 MET-h/wk; P for trend = 0.05). Results were similar for overall survival (HR, 0.44; 95% CI, 0.32-0.60 for > or =21.0 versus <2.8 MET-h/wk; P for trend <0.001) and were similar regardless of a woman's age, stage of disease, and body mass index. This study provides support for reduced overall mortality and mortality from breast cancer among women who engage in physical activity after breast cancer diagnosis.

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    ABSTRACT: Purpose Survivors of Hodgkin lymphoma (HL) are at increased risk of treatment-related cardiovascular (CV) events; whether exercise modifies this risk is unknown. Methods Survivors of HL (n = 1,187; median age, 31.2 years) completed a questionnaire evaluating vigorous-intensity exercise behavior. CV events were collected in follow-up questionnaires and graded according to Common Terminology Criteria for Adverse Events (version 4.03). The primary end point was incidence of any major (grade 3 to 5) CV event. Poisson regression analyses were used to estimate the association between exercise exposure (metabolic equivalent [MET] hours/week(-1)) and risk of major CV events after adjustment for clinical covariates and cancer treatment. Results Median follow-up was 11.9 years (range, 1.7 to 14.3 years). Cumulative incidence of any CV event was 12.2% at 10 years for survivors reporting 0 MET hours/week(-1) compared with 5.2% for those reporting >= 9 MET hours/week(-1). In multivariable analyses, the incidence of any CV event decreased across increasing MET categories (P-trend = .002). Compared with survivors reporting 0 MET hours/week(-1), the adjusted rate ratio for any CV event was 0.87 (95% CI, 0.56 to 1.34) for 3 to 6 MET hours/week(-1), 0.45 (95% CI, 0.26 to 0.80) for 9 to 12 MET hours/week(-1), and 0.47 (95% CI, 0.23 to 0.95) for 15 to 21 MET hours/week(-1). Adherence to national vigorous intensity exercise guidelines (ie, >= 9 MET hours/week-1) was associated with a 51% reduction in the risk of any CV event in comparison with not meeting the guidelines (P = .002). Conclusion Vigorous exercise was associated with a lower risk of CV events in a dose-dependent manner independent of CV risk profile and treatment in survivors of HL. (C) 2014 by American Society of Clinical Oncology
    Journal of Clinical Oncology 10/2014; 32(32). DOI:10.1200/JCO.2014.56.7511 · 17.88 Impact Factor
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    ABSTRACT: Adverse health outcomes are often seen in breast cancer survivors due to prolonged treatment with side effects such as loss of energy and lack of physical strength. Physical activity (PA) has been proposed as an adequate intervention for women with breast cancer. Therefore, this review summarizes the effects of physical activity on breast cancer survivors after diagnosis. We searched electronic databases including PubMed, Medline, Embase, and Google Scholar for articles published between January 1980 and May 2013. We included a variety of studies such as randomized controlled trials, pilot studies, and clinical trials. We reviewed these studies for three major outcomes: changes in breast cancer mortality, physiological functions, and metabolic biomarkers. Of 127 studies, 33 studies were selected as eligible studies. These studies included physical activities of varying type, duration, frequency, and intensity (e.g., aerobic and resistance training) and examined changes in three major outcomes among breast cancer survivors. Many of the studies suggest that breast cancer survivors benefit from engaging in physical activity, but some studies were limited in their ability to provide adequate evidence due to relatively small sample sizes, short intervention periods, or high attrition. Based on epidemiological evidence, recent studies demonstrated that those breast cancer survivors who engaged in physical activity significantly lowered their risk of breast cancer mortality and improved their physiological and immune functions. Some studies demonstrated changes in metabolic biomarkers such as insulin and insulin-like growth factors. However, further investigation is required to support these findings because these results are not consistent.
    09/2013; 18(3):193-200. DOI:10.15430/JCP.2013.18.3.193
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    ABSTRACT: Objectives: To examine the contribution of social cognitive constructs to meeting physical activity (PA) recommendations in rural breast cancer survivors (BCS). Methods: Rural BCS (N = 483) completed a mail-based survey. PA, fatigue, barriers and exercise self-efficacy, environment, social support, and perceived barriers to PA were assessed. PA was dichotomized into either meeting guidelines (150+minutes/week) or not. Results: Our model fit the data well with less fatigue, greater efficacy, and lower barriers being associated with PA (chi(2)=804.532(418), p < .001, CFI=.948, RMSEA=.044, SRMR=.046). Conclusions: Fatigue, self-efficacy, and perceived barriers are key targets for future interventions designed to increase PA in rural BCS. Enhancing self-efficacy and overcoming barriers will require strategies unique and relevant to BCS living in rural settings.
    American journal of health behavior 11/2014; 38(6):890-9. DOI:10.5993/AJHB.38.6.11 · 1.31 Impact Factor


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