Article

Physical Activity and the Risk of Breast Cancer Recurrence: A Literature Review

Paul D. Loprinzi

Bradley J. Cardinal

Kerri Winters-Stone

Ellen Smit

Charles Loprinzi

literature review, physical activity, breast cancer
ONF 2012, 39(3), 269-274. DOI: 10.1188/12.ONF.269-274

Purpose/Objectives: To examine the association between physical activity and breast cancer mortality and recurrence, and to provide an overview of factors related to physical activity behavior in women with breast cancer.

Data Sources: An extensive review of the epidemiologic literature on the effect of physical activity on breast cancer recurrence and mortality was conducted using PubMed up to December 2010, involving the following key words: physical activity, exercise, breast cancer, breast cancer recurrence, and breast cancer mortality.

Data Synthesis: For breast cancer recurrence and breast cancer-related mortality, studies were included if physical activity served as the independent variable and a measure of association was reported. To examine determinants of physical activity, studies were included if a hypothesized factor served as the independent variable and a measure of association was reported.

Conclusions: Of the six studies that examined the influence of physical activity on breast cancer mortality, four (67%) reported a protective effect (i.e., inverse association), two examined the influence of physical activity on breast cancer recurrence and reported a nonsignificant risk reduction. Few studies have examined factors that influence physical activity behavior in women with breast cancer, and findings suggest that psychosocial factors play an important role in influencing the activity patterns of breast cancer survivors. Future longitudinal studies are needed to confirm those findings.

Implications for Nursing: To prevent breast cancer recurrence and breast cancer-related mortality, nurses should encourage breast cancer survivors to engage in regular exercise.

Jump to a section

    References

    Abrahamson, P. E., Gammon, M. D., Lund, M. J., Britton, J. A., Marshall, S. W., Flagg, E. W., … Coates, R. J. (2006). Recreational physical activity and survival among young women with breast cancer. Cancer, 107, 1777-1785. doi:10.1002/cncr.22201
    Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, S. J., Strath, W. L., … Leon, A. S. (2000). Compendium of phsical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32(Suppl.), S498-S516.
    Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.
    Andrykowski, M. A., Beacham, A. O., & Jacobsen, P. B. (2007). Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancer. Cancer Epidemiology, Biomarkers and Prevention, 16, 430-438.
    Cardinal, B. J., Kosma, M., & McCubbin, J. A. (2004). Factors influencing the exercise behavior of adults with physical disabilities. Medicine and Science in Sports and Exercise, 36, 868-875. doi:10.1249/01.MSS.0000126568.63402.22
    Courneya, K. S., Friedenreich, C. M., Reid, R. D., Gelmon, K., Mackey, J. R., Ladha, A. B., … Segal, R. J. (2009). Predictors of follow-up exercise behavior six months after a randomized trial of exercise training during breast cancer chemotherapy. Breast Cancer Research and Treatment, 114, 179-187. doi:10.1007/s10549-008-9987-3
    Courneya, K. S., Segal, R. J., Gelmon, K., Reid, R. D., Mackey, J. R., Friedenreich, C. M., … McKenzie, D. C. (2008). Predictors of supervised exercise adherence during breast cancer chemotherapy. Medicine and Science in Sports and Exercise, 40, 1180-1187. doi:10.1249/MSS.0b013e318168da45
    Friedenreich, C. M., Gregory, J., Kopciuk, K. A., Mackey, J. R., & Courneya, K. S. (2009). Prospective cohort study of lifetime physical activity and breast cancer survival. International Journal of Cancer, 124, 1954-1962. doi:10.1002/ijc.24155
    Garner, C., & Page, S. J. (2005). Applying the transtheoretical model to the exercise behaviors of stroke patients. Topics in Stroke Rehabilitation, 12, 69-75.
    Harrison, S., Hayes, S. C., & Newman, B. (2009). Level of physical activity and characteristics associated with change following breast cancer diagnosis and treatment. Psycho-Oncology, 18, 387-394. doi:10.1002/pon.1504
    Hesse, B. W., Nelson, D. E., Kreps, G. L., Croyle, R. T., Arora, N. K., Rimer, B. K., & Viswanath, K. (2005). Trust and sources of health information: The impact of the Internet and its implications for healthcare providers: Findings from the first Health Information National Trends Survey. Archives of Internal Medicine, 165, 2618-2624. doi:10.1001/archinte.165.22.2618
    Holick, C. N., Newcomb, P. A., Trentham-Dietz, A., Titus-Ernstoff, L., Bersch, A. J., Stampfer, M. J., … Willett, W. C. (2008). Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiology, Biomarkers and Prevention, 17, 379-386.
    Holmes, M. D., Chen, W. Y., Feskanich, D., Kroenke, C. H., & Colditz, G. A. (2005). Physical activity and survival after breast cancer diagnosis. JAMA, 293, 2479-2486. doi:10.1001/jama.293.20.2479
    Hong, S., Bardwell, W. A., Natarajan, L., Flatt, S. W., Rock, C. L., Newman, V. A., … Pierce, J. P. (2007). Correlates of physical activity level in breast cancer survivors participating in the Women's Healthy Eating and Living (WHEL) Study. Breast Cancer Research and Treatment, 101, 225-232. doi:10.1007/s10549-006-9284-y
    Ibrahim, E. M., & Al-Homaidh, A. (2011). Physical activity and survival after breast cancer diagnosis: Meta-analysis of published studies. Medical Oncology, 28, 753-765. doi:10.1007/s12032-010-9536-x
    Irwin, M. L., George, S. M., & Matthews, C. E. (2010). Physical activity and breast cancer: Prevention, survival, and mechanisms. Research Digest, 11, 1-9. Retrieved from http://www.presidentschallenge.org/informed/digest/docs/sept2010digest… http://www.presidentschallenge.org/informed/digest/docs/sept2010digest.pdf
    Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R., Cronin, K., Gilliland, F. D., … Bernstein, L. (2008). Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study. Journal of Clinical Oncology, 26, 3958-3964. doi:10.1200/JCO.2007.15.9822
    Marshall, S. J., & Biddle, S. (2001). The Transtheoretical Model of Behavior Change: A meta-analysis of applications to physical activity and exercise. Annals of Behavioral Medicine, 23, 229-246. doi:10.1207/S15324796ABM2304_2
    Milne, H. M., Wallman, K. E., Guilfoyle, A., Gordon, S., & Corneya, K. S. (2008). Self-determination theory and physical activity among breast cancer survivors. Journal of Sport and Exercise Psychology, 30, 23-38.
    Pierce, J. P., Stefanick, M. L., Flatt, S. W., Natarajan, L., Sternfeld, B., Madlensky, L., … Rock, C. L. (2007). Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. Journal of Clinical Oncology, 25, 2345-2351. doi:10.1200/JCO.2006.08.6819
    Pinto, B. M., Maruyama, N. C., Clark, M. M., Cruess, D. G., Park, E., & Roberts, M. (2002). Motivation to modify lifestyle risk behaviors in women treated for breast cancer. Mayo Clinic Proceedings, 77, 122-129. doi:10.4065/77.2.122
    Pinto, B. M., Rabin, C., & Dunsiger, S. (2009). Home-based exercise among cancer survivors: Adherence and its predictors. Psycho-Oncology, 18, 369-376. doi:10.1002/pon.1465
    U. S. Cancer Statistics Working Group. (2010). United States cancer statistics: 1999-2006 Incidence and mortality web-based report. Retrieved from http://cdc.gov/uscs
    U. S. Department of Health and Human Services. (20008). Physical activity guidelines for Americans. Retrieved from http://www.health.gov/paguides/
    Wood, M. E. (2008). Theoretical framework to study exercise motivation for breast cancer risk reduction. Oncology Nursing Forum, 35, 89-95. doi:10.1188/08.ONF.89-95