Accumulating evidence suggests that exercise, long known to be a fundamental part of general health maintenance, may have additional benefits for breast cancer survivors. Observational evidence suggests that women who exercise after breast cancer diagnosis have lower rates of recurrence and death compared with sedentary individuals. A growing number of exercise intervention studies show that increased physical activity after diagnosis leads to improvements in quality of life, fatigue, and body image, amongst other end points, and preliminary work shows that exercise can lead to improvements in biomarkers linked to breast cancer prognosis.
ThuneIFerbergA. Physical activity and cancer risk: dose-response and cancer, all sites and site specific. Med Sci Sports Exerc2001;33:S530–550.
McTiernanAKooperbergCWhiteE. Recreational physical activity and the risk of breast cancer in postmenopausal women. JAMA2003;290:1331–1336.
MarutiSWillettWFeshanichD. A prospective study of age-specific physical activity and premenopausal breast cancer. J Natl Cancer Inst2008;100:728–737.
FriedenreichCMCustAE. Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br J Sports Med2008;42:636–647.
HolickCNewcombPTrentham-DietzA. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev2008;17:379–386.
IrwinMSmithAMcTiernanA. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the Health, Eating, Activity, and Lifestyle study. J Clin Oncol2008;26:3958–3964.
PierceJStefanickMFlattS. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol2007;17:2345–2351.
SternfeldBWeltzienEQuesenberryCPJr. Physical activity and risk of recurrence and mortality in breast cancer survivors: findings from the LACE study. Cancer Epidemiol Biomarkers Prev2009;18:87–95.
SchmitzKHCourneyaKSMatthewsC. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc2010;42:1409–1426.
McNeelyMCampbellKRoweB. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ2006;175:34–41.
AhmedRLThomasWYeeDSchmitzKH. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol2006;24:2765–2772.
McNeelyMLCampbellKOspinaM. Exercise interventions for upper-limb dysfunction due to breast cancer treatment. Cochrane Database Syst Rev2010;CD005211.
KeyTApplebyPBarnesI. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst2002;94:606–612.
GoodwinPEnnisMPritchardKTrudeauM. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol2002;20:42–51.
PollakMChapmanJShepherdL. Insulin resistance, estimated by serum C-peptide level, is associated with reduced event-free survival for postmenopausal women in NCIC CTG MA.14 adjuvant breast cancer trial. J Clin Oncol2006;24:524.
HanksinsonSWillettWColditzG. Circulating concentrations of insulin-like growth factor-1 and risk of breast cancer. Lancet1998;351:1393–1396.
NeilsonHFriedenreichCBrocktonNMillikanR. Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev2009;18:11–27.
PierceBLBallard-BarbashRBernsteinL. Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J Clin Oncol2009;27:3437–3444.
IrwinMMcTiernanABernsteinL. Relationship of obesity and physical activity with C-peptide, leptin, and insulin-like growth factors in breast cancer survivors. Cancer Epidemiol Biomarkers Prev2005;14:2881–2888.
LigibelJAGiobbie-HurderAOlenczukD. Impact of a mixed strength and endurance exercise intervention on levels of adiponectin, high molecular weight adiponectin and leptin in breast cancer survivors. Cancer Causes Control2009;20:1523–1528.
IrwinMVarmaKAlvarez-ReevesM. Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study. Cancer Epidemiol Biomarkers Prev2009;18:306–313.
FrankLSorensenBYasuiY. Effects of exercise on metabolic risk variables in overweight postmenopausal women: a randomized clinical trial. Obes Res2005;13:615–625.
CampbellPTCampbellKLWenerMH. A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc2009;41:1533–1539.
ThompsonH. Effects of physical activity and exercise on experimentally-induced mammary carcinogenesis. Breast Cancer Res Treat1997;46:135–141.
JiangWZhuZThompsonHJ. Effects of physical activity and restricted energy intake on chemically induced mammary carcinogenesis. Cancer Prev Res (Phila)2009;2:338–344.
DoyleCKushiLByersT. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin2006;56:323–353.