Physical activity and survival after breast cancer diagnosis: Meta-analysis of published studies
Abstract
Published data have shown that physical activity (PA) has a positive role on the primary prevention of breast cancer risk. However, the role of PA on breast cancer outcome has been controversial with inconsistent data. The lack of a meta-analysis that addresses that issue prompted the current report. A comprehensive literature search identified eight studies, of which two studies were excluded. The remaining six studies (12,108 patients with breast cancer) were included in this meta-analysis. Pre-diagnosis PA reduced all causes mortality by 18% but had no effect on breast cancer deaths. Post-diagnosis PA reduced breast cancer deaths by 34% (HR=0.66, 95% CI, 0.57-0.77, P<0.00001), all causes mortality by 41% (HR=0.59, 95% CI, 0.53-0.65, P<0.00001), and disease recurrence by 24% (HR=0.76, 95% CI, 0.66-0.87, P=0.00001). Breast cancer mortality was reduced by pre-diagnosis PA in women with body mass index (BMI)<25 kg/m2, while post-diagnosis PA reduced that risk among those with BMI≥25 kg/m2. On the other hand, post-diagnosis PA reduced all causes mortality regardless of the BMI. The analysis showed that post-diagnosis PA reduced breast cancer deaths (HR=0.50, 95% CI, 0.34-0.74, P=0.0005), and all causes mortality (HR=0.36, 95% CI, 0.12-1.03, P=0.06) among patients with estrogen receptor (ER)-positive tumor, while women with ER-negative disease showed no gain. The current meta-analysis provides evidence for an inverse relationship between PA and mortality in patients with breast cancer and supports the notion that appropriate PA should be embraced by breast cancer survivors.
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Scientific evidence supports the safety and effectiveness of physical activity for people with cancer, indicating health benefits such as reduced anxiety, reduced depressive symptoms, reduced fatigue, improved quality of life, and improved physical function.
“Scientific evidence supports the safety and effectiveness of physical activity, indicating—for people with cancer experience—health benefits such as reduced anxiety, reduced depressive symptoms, reduced fatigue, improved quality of life, and improved physical function [40,41,42,43].”
From The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic (2023) · cites this paper as [42]
Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Parmar, M. K. B., Torri, V., & Stewart, L. (1998) · Statistics in Medicine · doi:10.1002/(sici)1097-0258(19981230)17:24 · Cited by 4,519 · see citing works
Quantitative Synthesis in Systematic Reviews
Lau, J., Ioannidis, J. P. A., & Schmid, C. H. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-127-9-199711010-00008 · Cited by 2,517 · cited 1× · see citing works
“1, the assumption of homogeneity was deemed invalid, and the random-effects model was reported after exploring the causes of heterogeneity [18].”
BackgroundPhysical activity and survival after breast cancer diagnosis
Holmes, M. D. (2005) · JAMA · doi:10.1001/jama.293.20.2479 · Cited by 1,772 · see citing works
Physical activity levels before and after a diagnosis of breast carcinoma
Irwin, M. L., Crumley, D., McTiernan, A., Bernstein, L., Baumgartner, R., Gilliland, F. D., Kriska, A. M., & Ballard-Barbash, R. R. (2003) · Cancer · doi:10.1002/cncr.11227 · Cited by 615 · see citing works
Assessment of physical activity in epidemiologic research: problems and prospects.
LaPorte, R. E., Montoye, H. J., & Caspersen, C. J. (1985) · Europe PMC (PubMed Central) · Cited by 587 · see citing works
Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R. R., Cronin, K. A., Gilliland, F. D., Baumgartner, R., Baumgartner, K. B., & Bernstein, L. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.15.9822 · Cited by 563 · see citing works
Physical Activity and Survival after Diagnosis of Invasive Breast Cancer
Holick, C. N., Newcomb, P., Trentham-Dietz, A., Titus-Ernstoff, L., Bersch, A., Stampfer, M., Baron, J., Egan, K., & Willett, W. (2008) · Cancer Epidemiology, Biomarkers and Prevention · doi:10.1158/1055-9965.epi-07-0771 · Cited by 518 · see citing works
Physical Activity and Breast Cancer: A Systematic Review
Monninkhof, E. M., Elias, S. G., Vlems, F. A., van der Tweel, I., Schuit, A. J., Voskuil, D. W., & van Leeuwen, F. E. (2007) · Epidemiology · doi:10.1097/01.ede.0000251167.75581.98 · Cited by 503 · see citing works
Physical activity and cancer risk: dose-response and cancer, all sites and site-specific
Thune, I., & Furberg, A. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200106001-00025 · Cited by 466 · see citing works
Pierce, J. P., Stefanick, M. L., Flatt, S. W., Natarajan, L., Sternfeld, B., Madlensky, L., Al‐Delaimy, W. K., Thomson, C. A., Kealey, S., Hajek, R., et al. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2006.08.6819 · Cited by 463 · see citing works
Nutrition, hormones, and breast cancer: Is insulin the missing link?
Kaaks, R. (1996) · Cancer Causes & Control · doi:10.1007/bf00051703 · Cited by 361 · see citing works
Friedenreich, C. M., & Cust, A. E. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2006.029132 · Cited by 345 · see citing works
Effect of Exercise on Serum Estrogens in Postmenopausal Women
McTiernan, A., Tworoger, S. S., Ulrich, C. M., Yasui, Y., Irwin, M. L., Rajan, K. B., Sorensen, B. E., Rudolph, R. E., Bowen, D. J., Stanczyk, F. Z., et al. (2004) · Cancer Research · doi:10.1158/0008-5472.can-03-3393 · Cited by 338 · see citing works
Frisch, R. E., Wyshak, G., Albright, N. L., Albright, T. E., Schiff, I., Jones, K., Witschi, J. C., Shiang, E. L., Koff, E., & Marguglio, M. (1985) · British Journal of Cancer · doi:10.1038/bjc.1985.273 · Cited by 322 · see citing works
Weight control and physical activity in cancer prevention: international evaluation of the evidence.
Vainio, H., Kaaks, R., & Bianchini, F. (2002) · PubMed · Cited by 259 · see citing works
The strengths and limitations of meta-analyses based on aggregate data
Lyman, G. H., & Kuderer, N. M. (2005) · BMC Medical Research Methodology · doi:10.1186/1471-2288-5-14 · Cited by 250 · see citing works
Sternfeld, B., Weltzien, E. K., Quesenberry, C. P., Castillo, A., Kwan, M. L., Slattery, M. L., & Caan, B. J. (2009) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-08-0595 · Cited by 229 · see citing works
Fairey, A., Courneya, K. S., Field, C. J., Bell, G. J., Jones, L. W., & Mackey, J. R. (2003) · PubMed · Cited by 225 · see citing works
Weight control and physical activity in cancer prevention
Bianchini, F., Kaaks, R., & Vainio, H. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00046.x · Cited by 223 · see citing works
Torjesen, P. A., Birkeland, K. I., Anderssen, S. A., Hjermann, I., Holme, I., & Urdal, P. (1997) · Diabetes Care · doi:10.2337/diacare.20.1.26 · Cited by 196 · see citing works
Body size and breast cancer prognosis: A critical review of the evidence
Goodwin, P. J., & Boyd, N. F. (1990) · Breast Cancer Research and Treatment · doi:10.1007/bf01806329 · Cited by 150 · see citing works
Borugian, M. J., Sheps, S. B., Kim‐Sing, C., Patten, C. L. V., Potter, J. D., Dunn, B. P., Gallagher, R. P., & Hislop, T. G. (2004) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.1163.13.7 · Cited by 138 · see citing works
Jernström, H., & Barrett-Connor, E. L. (1999) · Journal of Women s Health & Gender-Based Medicine · doi:10.1089/jwh.1.1999.8.1265 · Cited by 104 · see citing works
Recreational physical activity and survival among young women with breast cancer
Abrahamson, P. E., Gammon, M. D., Lund, M. J., Britton, J. A., Marshall, S. W., Flagg, E. W., Porter, P. L., Brinton, L. A., Eley, J. W., & Coates, R. J. (2006) · Cancer · doi:10.1002/cncr.22201 · Cited by 100 · see citing works
A REVIEW OF PHYSICAL ACTIVITY AND BREAST CANCER
Friedenreich, C. M., & Rohan, T. E. (1995) · Epidemiology · doi:10.1097/00001648-199505000-00021 · Cited by 84 · see citing works
Exercise activity, body size and premenopausal breast cancer survival
Enger, S. M., & Bernstein, L. (2004) · British Journal of Cancer · doi:10.1038/sj.bjc.6601820 · Cited by 80 · see citing works
Wilson, D., Porter, J. S., Parker, G., & Kilpatrick, J. (2005) · PubMed Central · Cited by 76 · see citing works
Epidemiologic issues related to the association between physical activity and breast cancer
Friedenreich, C. M., Thune, I., Brinton, L. A., & Albanes, D. (1998) · Cancer · doi:10.1002/(sici)1097-0142(19980801)83:3+ · Cited by 50 · see citing works
Lee, I.-M. M. (2003) · JAMA · doi:10.1001/jama.290.10.1377 · Cited by 26 · see citing works
Corn, B. W., Schnall, M. D., Milestone, B. N., King, S. A., Hauck, W. W., & Solin, L. J. (1996) · Cancer · doi:10.1002/(sici)1097-0142(19961215)78:12 · Cited by 3 · see citing works
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Cited by
Sorted by citations
Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases
Pedersen, B. K., & Saltin, B. (2015) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12581 · Cited by 3,514 · see citing works
Nutrition and physical activity guidelines for cancer survivors
Rock, C. L., Doyle, C., Demark‐Wahnefried, W., Meyerhardt, J., Courneya, K. S., Schwartz, A. L., Bandera, E. V., Hamilton, K. K., Grant, B., McCullough, M., et al. (2012) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21142 · Cited by 1,995 · see citing works
Physical Activity and Mortality in Cancer Survivors: A Systematic Review and Meta-Analysis
Friedenreich, C. M., Stone, C. R., Cheung, W. Y., & Hayes, S. C. (2020) · JNCI Cancer Spectrum · doi:10.1093/jncics/pkz080 · Cited by 453 · see citing works
Clinical Oncology Society of Australia position statement on exercise in cancer care
Cormie, P., Atkinson, M., Bucci, L., Cust, A., Eakin, E., Hayes, S., McCarthy, A. L., Murnane, A., Patchell, S., & Adams, D. (2018) · Medical Journal of Australia · doi:10.5694/mja18.00199 · Cited by 452 · see citing works
Singh, B., Spence, R. R., Steele, M. L., Sandler, C. X., Peake, J. M., & Hayes, S. C. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.03.026 · Cited by 146 · see citing works
From obesity to cancer: a review on proposed mechanisms
Tahergorabi, Z., Khazaei, M., Moodi, M., & Chamani, E. (2016) · Cell Biochemistry and Function · doi:10.1002/cbf.3229 · Cited by 118 · see citing works
Effects of physical exercise on survival after allogeneic stem cell transplantation
Wiskemann, J., Kleindienst, N., Kuehl, R., Dreger, P., Schwerdtfeger, R., & Bohus, M. (2015) · International Journal of Cancer · doi:10.1002/ijc.29633 · Cited by 96 · see citing works
Gosain, R., Gage-Bouchard, E., Ambrosone, C., Repasky, E., & Gandhi, S. (2020) · Seminars in Immunopathology · doi:10.1007/s00281-020-00815-y · Cited by 85 · see citing works
Exercise following breast cancer: exploratory survival analyses of two randomised, controlled trials
Hayes, S. C., Steele, M. L., Spence, R. R., Gordon, L., Battistutta, D., Bashford, J., Pyke, C., Saunders, C., & Eakin, E. (2018) · Breast Cancer Research and Treatment · doi:10.1007/s10549-017-4541-9 · Cited by 82 · see citing works
Travier, N., Fonseca-Nunes, A., Javierre, C., Guillamo, E., Arribas, L., Peiró, I., Buckland, G., Moreno, F., Urruticoechea, A., Oviedo, G. R., et al. (2014) · Medical Oncology · doi:10.1007/s12032-013-0783-5 · Cited by 66 · see citing works
Phillips, S. M., & McAuley, E. (2014) · Psycho-Oncology · doi:10.1002/pon.3366 · Cited by 60 · see citing works
Cho, D., & Park, C. L. (2018) · European Journal of Cancer Care · doi:10.1111/ecc.12772 · Cited by 55 · see citing works
Yun, Y. H., Kim, Y. A., Lee, M. K., Sim, J. A., Nam, B.-H., Kim, S., Lee, E. S., Noh, D.-Y., Lim, J.-Y., Kim, S., et al. (2017) · BMC Cancer · doi:10.1186/s12885-017-3290-9 · Cited by 47 · see citing works
Significantly greater reduction in breast cancer mortality from post-diagnosis running than walking
Williams, P. T. (2014) · International Journal of Cancer · doi:10.1002/ijc.28740 · Cited by 40 · see citing works
Zok, A., Matecka, M., Zapala, J., Izycki, D., & Baum, E. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043770 · Cited by 12 · see citing works
- Authors
- Ibrahim, E. M., & Al-Homaidh, A.
- Affiliations
- International Medical Center in Jeddah (SA)
- Corresponding author
- Ibrahim, Ezzeldin M.
- ORCID
- Ibrahim, Ezzeldin M.
- Venue
- Medical Oncology
- Published
- 2010-04-22
- Volume
- 28
- Issue
- 3
- Pages
- 753-765
- ISSN
- 1357-0560 (ISSN-L)
- 1559-131X
- OpenAlex
- W2136405350
- Cited by
- 604
- References
- 32
- Citations by year
- 2026: 4 · 2025: 22 · 2024: 26 · 2023: 18 · 2022: 40 · 2021: 43 · 2020: 54 · 2019: 44 · 2018: 54 · 2017: 54 · 2016: 50 · 2015: 47 · 2014: 48 · 2013: 36 · 2012: 35
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Medical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- physical activity, breast cancer, survival, breast cancer mortality, all-cause mortality, recurrence, body mass index, estrogen receptor status, breast cancer survivors
- MeSH terms
- Breast Neoplasms, Female, Humans, Exercise
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