Physical Activity and Survival after Diagnosis of Invasive Breast Cancer

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 z21.0 MET-h/wk; P for trend = 0.05). Results were similar for overall survival (HR, 0.44; 95% CI, 0.32-0.60 for z21.0 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. (Cancer Epidemiol Biomarkers Prev 2008;17(2):379 -86)

Breast Cancer Survivors' Efforts to Renew and Preserve Their Health in Taiwan

“…Many participants began exercising in an effort to improve their health. This result is similar to othersstudies that have indicated that exercise can enhance health and prevent cancer recurrence (Norman et al, 2007;Holick et al, 2008;Weiner et al, 2010;Magné et al, 2011). The results of this study show that many participants practiced Qigong to restore balance to the body.…”

“…Similarly, other studies have pointed toward cancer survivors attempted to change their unhealthy behaviors (Norman et al, 2007;Demark-Wahnefried et al, 2008 ;Holick et al, 2008;Weiner et al, 2010;Magné et al, 2011). Chinese culture emphasizes health preservation.…”

“…For example, they stopped smoking, made healthy food choices, and increased their levels of physical activity, which promoted good health and improved their quality of life (Norman et al, 2007;Demark-Wahnefried et al, 2008;Holick, et al, 2008;Magné et al, 2011;Weiner et al, 2010). Therefore, cancer patients took action to reduce stress or change their mood, which improved their lifestyle.…”

Lifestyle changes and breast cancer prognosis: a review

“…Similar results were found by a cohort study of 4,482 invasive breast cancer patients [13] and for two studies that investigated the relationship between breast cancer mortality and pre-diagnostic physical activity [14,15]. Results from the WHEL study indicated that the combination of consuming at least five servings of vegetables-fruits and physical activity (30 min of walking at moderate pace for 6 days a week) is associated with an increase in survival in women with estrogen-positive receptor tumours [16].…”

Effect of aerobic exercise on tumor physiology in an animal model of human breast cancer

“…Systematic reviews conclude that exercise is a safe and feasible supportive intervention associated with significant improvements in patient-reported outcomes (e.g., quality of life, fatigue) as well as physiological outcomes (exercise tolerance, muscle strength) in cancer populations (3,21). Moreover, several landmark epidemiologic studies have provided the first evidence that regular moderate-intensity exercise is associated with a 30 -50% reduction in the risk of cancer-specific mortality and all-cause mortality following a diagnosis of early breast or colorectal cancer (14,16,28). As such, elucidation of the molecular mechanisms underlying this association is of paramount importance to optimize the safety and efficacy of exercise in cancer control.…”