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Cited by 82Cancer survivorship and careCancer Risks and FactorsBreast Cancer Treatment Studies

Exercise following breast cancer: exploratory survival analyses of two randomised, controlled trials

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Hayes, S. C., Steele, M. L., Spence, R. R., Gordon, L., Battistutta, D., Bashford, J., Pyke, C., Saunders, C. +1 more·2018·Breast Cancer Research and Treatment
DOI 10.1007/s10549-017-4541-9
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Abstract

Purpose The Exercise for Health trials were randomised, controlled trials designed to evaluate an 8-month pragmatic exercise intervention, commencing 6 weeks post-surgery for women with newly diagnosed breast cancer residing in urban or rural/regional Australia. For these exploratory analyses, the primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively.Methods Consenting urban- (n = 194) and rural/regional-residing women (n = 143) were randomised to exercise (intervention delivered face-to-face or by telephone) or usual care. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for survival outcomes (exercise group, n = 207, 65% urban women; usual care group, n = 130, 46% urban women).Results After a median follow-up of 8.3 years, there were 11 (5.3%) deaths in the exercise group compared with 15 (11.5%) deaths in the usual care group (OS HR for the exercise group: 0.45, 95% CI 0.20-0.96; p = 0.04). DFS events for the exercise versus usual care group were 25 (12.1%) and 23 (17.7%), respectively (HR: 0.66, 95% CI 0.38-1.17; p = 0.16). HRs for OS favoured exercise irrespective of age, body mass index, stage of disease, intervention compliance, and physical activity levels at 12 months post-diagnosis, although were stronger (p < 0.05) for younger women, women with stage II + disease, women with 1 + comorbidity at time of diagnosis, higher intervention compliance and for those who met national physical activity guidelines at 12 months post-diagnosis.Conclusion An exercise intervention delivered during and beyond treatment for breast cancer, and that was designed to cater for all women irrespective of place of residence and access to health services, has clear potential to benefit survival. Trial numbers: ACT RN: 012606000233527; ACT RN: 12609000809235.

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  • Reverse causation is unlikely to entirely explain the protective association between physical activity and survival in cancer survivors, based on preliminary randomized trial results.

    “While it is likely that reverse causation contributes to some of the association (i.e., those with better health and prognosis are more able to exercise), preliminary results from randomized trials showing the effect of exercise on survival suggest that bias is unlikely to entirely account for the protective association [9, 10].”

    From Physical activity for cancer patients during COVID-19 pandemic: A call to action (2021) · cites this paper as [10]

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Authors
Hayes, S. C., Steele, M. L., Spence, R. R., Gordon, L., Battistutta, D., Bashford, J., Pyke, C., Saunders, C., & Eakin, E.
Affiliations
  • Queensland University of Technology (AU)
  • QIMR Berghofer Medical Research Institute (AU)
  • Wesley Hospital (AU)
  • Mater Private Hospital (AU)
  • The University of Western Australia (AU)
  • The University of Queensland (AU)
Corresponding author
Hayes, S. C.
ORCID
Venue
Breast Cancer Research and Treatment
Publisher
Springer Science and Business Media LLC
Published
2017-10-23
Volume
167
Issue
2
Pages
505-514
ISSN
  • 0167-6806 (ISSN-L)
  • 1573-7217
DOI
10.1007/s10549-017-4541-9
OpenAlex
W2766050064
Cited by
82
References
12
Citations by year
2026: 5 · 2025: 5 · 2024: 10 · 2023: 11 · 2022: 10 · 2021: 11 · 2020: 15 · 2019: 14 · 2018: 1
FWCI
3.64
Type
journal article
Language
en
Update notices
correction (2017-11-10)
Open access
Licence
Locations
  • Breast Cancer Research and Treatment (publishedVersion)
  • PubMed (publishedVersion)
  • QUT ePrints (Queensland University of Technology) (submittedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
  • Griffith Research Online (submittedVersion, other-oa)
Funders
National Breast Cancer Foundation
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Keywords
breast cancer, exercise intervention, physical activity, overall survival, disease-free survival, intervention adherence, physical activity guidelines, comorbidities
MeSH terms
Adult, Australia, Breast Neoplasms, Exercise Therapy, Female, Humans, Middle Aged, Neoplasm Staging, Quality of Life, Exercise, Disease-Free Survival, Kaplan-Meier Estimate

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