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.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Epidemiological evidence supports a protective effect of physical activity for breast cancer but pre-clinical studies are needed to help define the underlying mechanisms in an age-related manner. We utilized 18-month old BALB/c mice injected in the mammary fat pad with syngeneic 4T1 tumor cells as a model of invasive breast cancer. A negative correlation was observed between daily distance ran, prior to tumor injection, and absolute tumor mass measured at necropsy (Pearson's r = -0.89, P = 0.0066, R(2) = 0.80). A correlation was also observed between distance ran before tumor implant and the histological score for mitotic index (Pearson's r = -0.85, P = 0.034, R(2) = 0.72). Runners showed an increased respiratory exchange ratio during the light cycle (P = 0.029) suggesting that voluntary running shifted resting substrate metabolism toward glucose oxidation, relative to lipid oxidation. The shift in substrate metabolism was significantly different from baseline for both groups of animals, indicating that the tumor burden might have been responsible. The observations from this study indicate that running longer distances is associated with decreased breast tumor burden in old mice, suggesting that physiological factors generated by exercising before tumor onset are protective against tumor progression. The mechanisms for this protective effect are not known but the data show that older mice are useful models to address specific questions in cancer research and support further studies on the ability of exercise training to protect older women at risk for breast cancer.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Physical inactivity is identified as the fourth leading risk factor for global mortality and associated with increased breast cancer diagnosis and risks of recurrence. Objectives: To investigate the level of physical activity engagement after breast cancer in survivors and healthy controls. Design: A descriptive casecontrol study on survivors and matched (ethnic, gender, age) healthy controls was surveyed using a pre-post questionnaire and a 1-minute cancer control media. The socio- and medical demographic data, physical activity status information were obtained from self report questionnaires. Results: Breast cancer survivors (n = 51) were found to participate in low-moderate level of physical activity while healthy controls (n = 45) participated in moderate-vigorous level of physical activity. Healthy adults reported more barriers and excuses but all participants (90% survivors and control) were unaware of the strong inverse relationship between level of physical activity and risks of cancer recurrence. The post test on video showed an increased awareness and intention to re-engagement in physical activity for cancer control (M = 7.1 ± 1.53, p < 0.01). Conclusion: The finding suggests that simple public health message within the Model of cancer survivorship care must be disseminated. The “teachable moments” after a cancer diagnosis should be optimised to promote rehabilitation for physically active lifestyle.
    Health 06/2013; 5:838-846. · 0.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Physical activity is a component of lifestyle activity and one that has been increasingly seen as 'the medicine' to cure chronic diseases, including certain types of cancer. Physical activity has potent impact on mortality but only if it is well incorporated as lifestyle activity may it allow a better outcome of the quality of life of cancer survivors. This paper presents a review on the evidence of physical activity being actively promoted as lifestyle activity amongst cancer survivors, for the last five years. Materials and Methods: Electronic databases were systematically searched for randomized controlled trials incorporated as lifestyle activity through MEDLINE with the associated terms "physical activity or exercise", "quality of life" and "cancer survivor or people with cancer", 'lifestyle' and 'randomised controlled trial'. The period of search was confined to publication within January 2008 till December 2012 and further limits were to full text, peer reviewed, abstract available and English language. Results: Based on inclusion criteria, 45 articles were retrieved. Of these, 41 were excluded after examining the full paper. Four final articles on randomized controlled trials were studied to determine the effectiveness of PA to improve the quality of life in post treatment cancer survivors and positive associations were found. Conclusions: Physical activity is related to better quality of life of cancer survivors. Only one paper had characteristics of lifestyle incorporation for a lifestyle redesign, but none overtly or actively promoting exercise interventions as an essential lifestyle activity. With increasing survivorship, the benefits of physical activity must be aggressively and overtly promoted to optimize its positive impact.
    Asian Pacific journal of cancer prevention: APJCP 04/2013; 14(4):2551-2555. DOI:10.7314/APJCP.2013.14.4.2551 · 2.51 Impact Factor


Available from