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Home > Understanding Breast Cancer > Breast Cancer Research > Table 59: Physical activity (exercise) and breast cancer survival

  


Table 59: Physical activity (exercise) and breast cancer survival

 

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Regular physical activity (exercise) appears to lower the risk of breast cancer (see Table 4).  

For breast cancer survivors, being active may lower the risk of:

  • Breast cancer recurrence  
  • Breast cancer-specific mortality (death from breast cancer)
  • Overall mortality (death from any cause, not necessarily breast cancer)

Regular physical activity has other health benefits for breast cancer survivors. It improves mood, physical condition and movement, which can increase quality of life [1,2].    

Learn more about the strengths and weaknesses of different types of studies

Study selection criteria: Prospective cohort studies with at least 900 participants, pooled analyses and meta-analyses.

Table notes: A relative risk above 1 indicates increased risk. A relative risk below 1 indicates decreased risk.

MET (metabolic equivalent) hours are often used as a unit of measure for physical activity. One MET hour equals the energy used to sit quietly for one hour. Activities are assigned MET scores based on this measure. For example, walking is 3 MET hours and swimming is 7 MET hours. Moderate activities, like mowing the lawn or slow dancing, range from 3 to 6 MET hours and vigorous activities, like playing tennis or jogging, score higher than 6 MET hours.   

Study 

Study Population
(number of participants)
 

Follow-up
(years)
 

Levels of Physical Activity Compared 

Breast Cancer Recurrence 
RR (95% CI) 

Overall Mortality
RR (95% CI) 

Prospective cohort studies 

Shanghai Breast Cancer Survival Study [3]

4,829

4

 Up to 8 MET hrs/wk
vs.
Inactive

0.60
(0.46-0.78)*

0.81
(0.63-1.05)

     

8 or more MET hrs/wk
vs.
Inactive

0.59
(0.45-0.76)*

0.65
(0.51-0.84)

Collaborative Women’s
Longevity Study [4]

4,482

6

3 to 8
vs.
Less than 3 MET hrs/wk

 

0.58
(0.45-0.76)†

     

8 to 21
vs.
Less than 3 MET hrs/wk

 

0.53
(0.40-0.69)†

     

21 or more
vs.
Less than 3 MET hrs/wk

 

0.44
(0.32-0.60)†

Nurses' Health Study [5]

2,987

8

3 to 9
vs.
Less than 3 MET hrs/wk

0.83
(0.64-1.08)

0.71
(0.56-0.89)†

     

9 to 15
vs.
Less than 3 MET hrs/wk

0.57
(0.38-0.85)

0.59
(0.41-0.84)†

     

15 to 24
vs.
Less than 3 MET hrs/wk

0.66
(0.47-0.93)

0.56
(0.41-0.77)†

     

24 or more
vs.
Less than 3 MET hrs/wk

0.74
(0.53-1.04)

0.60
(0.40-0.89)†

Women’s Health Initiative Observational Study [6]

2,910

3

 Up to 3 MET hrs/wk
vs.
Inactive  

 

0.42
(0.21-0.82)†

     

 3 to 9 MET hrs/wk
vs.
Inactive

 

0.72
(0.48-1.07)

     

 9 or more MET hrs/wk
vs.
Inactive

 

0.54
(0.38-0.79)†

Women’s Healthy Eating and Living (WHEL) Study [7]

2,361

7

25 or more
vs.
Less than 3 MET hrs/wk 

 0.74
(0.50-1.10)

 0.47
(0.26-0.84)

Life After Cancer
Epidemiology Study [8]

1,970

7

29 to 44
vs.
Less than 29 MET hrs/wk

0.76
(0.51-1.13)

0.89
(0.59-1.33)

Health, Eating, Activity and Lifestyle Study [9]

933

6

Up to 9 MET hrs/wk
vs.
Inactive  

 

0.36
(0.17-0.73)

     

9 or more MET hrs/wk
vs.
Inactive

 

0.33
(0.15-0.73)

Pooled and meta-analyses 

After Breast Cancer Pooling Project [10]

13,302
(4 studies)

 

10 or more
vs.
Less than 10 MET hrs/wk

0.96
(0.86-1.06)

0.73
(0.66-0.82)†

Schmid and Leitzmann [11]

4 studies

 

Active
vs.
Inactive

 

0.52
(0.42-0.64)†

Ibrahim and Homaidh [12]

4 studies

 

Active
vs.
Inactive

0.76
(0.66-0.87)

 0.59
(0.53-0.65)

Sig = Statistically significant trend of increasing survival with increasing levels of activity.

* Risk of recurrence and breast cancer-specific mortality.

† Results also showed significant decreases in breast cancer-specific mortality.

References 

  1. Mutrie N, Campbell AM, Whyte F, et al. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ. 334(7592):517, 2007.
  2. Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 25(13):1713-21, 2007.
  3. Chen X, Lu W, Zheng W, et al. Exercise after diagnosis of breast cancer in association with survival. Cancer Prev Res (Phila). 4(9):1409-18, 2011.
  4. Holick CN, Newcomb PA, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev. 17(2):379-86, 2008.
  5. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 293(20):2479-86, 2005.
  6. Irwin ML, McTiernan A, Manson JE, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the Women's Health Initiative. Cancer Prev Res (Phila). 4(4):522-9, 2011.
  7. Bertram LA, Stefanick ML, Saquib N, et al. Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study. Cancer Causes Control. 22(3):427-35, 2011.
  8. Sternfeld B, Weltzien E, Quesenberry CP Jr, et al. Physical activity and risk of recurrence and mortality in breast cancer survivors: findings from the LACE study. Cancer Epidemiol Biomarkers Prev. 18(1):87-95, 2009.
  9. Irwin ML, Smith AW, McTiernan A, et al. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol. 26(24):3958-64, 2008.
  10. Beasley JM, Kwan ML, Chen WY, et al. Meeting the physical activity guidelines and survival after breast cancer: findings from the after breast cancer pooling project. Breast Cancer Res Treat. 131(2):637-43, 2012.
  11. Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol. 2014 Mar 18. [Epub ahead of print].
  12. Ibrahim EM, Al-Homaidh A. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol. 28(3):753-65, 2011. 

Updated 05/16/14