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Home > Understanding Breast Cancer > Breast Cancer Research > Table 4: Exercise (physical activity) and breast cancer risk

  


Table 4: Exercise (physical activity) and breast cancer risk

  

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: Exercise (physical activity) may lower the risk of breast cancer. Although not all studies show this benefit, when the evidence is looked at as a whole, regular exercise seems to moderately lower risk. This is seen most clearly in postmenopausal women [1]. 

Learn more about exercise and breast cancer risk

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

See how this risk factor compares with other risk factors for breast cancer
 

 Komen Perspectives 

Read Komen’s perspective on physical activity and breast cancer risk
(December 2010).*
 

* Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.  

  

Study selection criteria: Prospective cohort studies with at least 700 breast cancer cases and meta-analyses.

Table notes: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk. 

MET (metabolic equivalent) hours are often used as a measure of physical activity. One MET hour equals the energy used to sit quietly for one hour. Different types of activity have different MET scores. 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 Activity Compared 

Relative Risk of Breast Cancer in Physically Active Women Compared to Inactive Women, RR (95% CI) 

Pre-menopausal  

Post-menopausal  

Pre- and post-menopausal combined 

Prospective cohort studies 

EPIC [2]

257,805
(8,034 cases)

12

More than 42
vs.
14 or fewer MET hrs/wk recreational activity 

0.88
(0.72-1.07)

0.97
(0.91-1.05)

0.96
(0.90-1.03)

NIH-AARP Diet and Health Study [3,4]

182,862
(6,609 cases)

7

At least 20 min activity at least 5 times/wk
vs.
inactive

 

0.92
(0.85-1.00)†

 

Nurses' Health Study [5]

95,396
(4,782 cases)

20

27 or more
vs.
less than 3 MET hr/wk

 

0.88
(0.79-0.98)

 

French E3N cohort [6]

90,509
(3,424 cases)

11

22-34 MET hr/wk recreational activity
vs.
inactive

   

0.88
(0.79-0.98) 

 

 

 

34 or more MET hr/wk recreational activity
vs.
inactive

   

0.81
(0.72-0.92) 

California Teachers Study [7]

110,599
(2,649 cases)

7

5 or more hr/wk moderate physical activity
vs.
inactive

   

1.03
(0.88-1.19)‡

Women’s Health Initiative [8]

155,723
(2,610 cases)

8

17 or more hr/wk
vs.
no activity 

 

0.85
(0.74-0.98)§

 

Iowa Women’s Health Study [9]

36,363
(2,548 cases)

15

High level of activity
vs.
low level

 

0.91
(0.82-1.01)

 

National Breast Cancer Screening Study-Canada [10]

40,318
(2,545 cases)

16

At least 1 hr/day vigorous physical activity
vs.
inactive

0.87
(0.68-1.09)

1.00
(0.78-1.29)

0.93
(0.78-1.10)

Cancer Prevention Study II (CPS II) [11]

72,608
(1,520 cases)

5

At least 42
vs.
less than 7 MET hr/wk


 

0.71
(0.49-1.02)


 

Norwegian-Swedish Women’s Lifestyle and Health Cohort Study [12]

99,504
(1,166 cases)

9

Vigorous activity
vs.
no activity

1.24
(0.85-1.82)||

   

Breast Cancer Detection Demonstration Project Follow-up Study [13]

32,269
(1,506 cases)

8

Higher
vs.
lower level of activity
 

0.87
(0.74-1.02)

 

Netherlands Cohort Study [14]

62,537
(1,208 cases)

7

More than 90 minutes/day of activity
vs.
less than 30 minutes/day

 

0.76
(0.58-0.99)

 

U.S. Radiologic Technologies cohort [15]

45,631
(864 cases)

9

At least 97
vs.
less than 10 MET hr/wk

   

0.91
(0.74-1.13)

 

 

 

Walking/hiking at least 10 hr/wk
vs.
never walking/hiking

   

0.57
(0.34-0.95)

Nurses’ Health Study II [16,17]

110,468
(849 cases)

10

27 or more
vs.
less than 3 MET hr/wk

1.04
(0.82-1.33)¶  

   

Shanghai Women’s Health Study [18]

73,049
(717 cases)

9

9-18 MET hr/wk
vs.
no activity 

   

0.69
(0.50-0.94)

 

   

18 or more MET hr/wk
vs.
no activity

   

0.92
(0.69-1.21)

PLCO Cancer Screening Trial [19]

27,541
(764 cases)

5

3 hr/wk recreational activity
vs.
inactive

 

1.02
(0.79-1.30)

 

 

   

4 or more hr/wk recreational activity
vs.
inactive

 

0.78
(0.61-0.99)

 

Meta-analyses 

Wu et al. [20]

7 studies
(19,882 cases)

 

10 MET hr/wk
vs.
no activity

   

0.97
(0.95-0.99)

† Additional analyses of 97,039 postmenopausal women (2,866 cases) found women whose daily routines included activities such as walking or heavy lifting/carrying had a lower risk of breast cancer compared to women who sat all day.

‡ Findings also showed a decreased risk of estrogen receptor-negative breast cancers among women with the highest levels of physical activity (more than 5 hours per week vs. inactive, RR was 0.53 (0.33-0.85)). There was no link between physical activity and risk of estrogen receptor-positive breast cancers.

§ Estrogen receptor-positive breast cancers only. For triple negative breast cancers (307 cases), the RR was 0.77 (0.51-1.13).

|| This study also found no link between physical activity at age 30 and breast cancer risk (vigorous activity vs. no activity 1.20 (0.77-1.95)), nor between physical activity at age 14 and breast cancer risk (vigorous activity vs. no activity, RR was 1.05 (0.72-1.54)).

¶ Among 64,777 premenopausal women in this study, average lifetime physical activity was found to decrease risk of breast cancer. Women who averaged at least 39 MET hours of activity a week during their lifetime had lower risk of breast cancer compared to inactive women, RR was 0.77 (0.64-0.93).  

 

References  

  1. International Agency for Research on Cancer (WHO): IARC Handbooks of Cancer Prevention, Volume 6: Weight Control and Physical Activity. IARC Press, Lyon, France, 2002.
  2. Steindorf K, Ritte R, Eomois PP, et al. Physical activity and risk of breast cancer overall and by hormone receptor status: The European prospective investigation into cancer and nutrition. Int J Cancer. 132(7):1667-78, 2013.
  3. Peters TM, Schatzkin A, Gierach GL, et al. Physical activity and postmenopausal breast cancer risk in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev. 18(1):289-96, 2009.
  4. George SM, Irwin ML, Matthews CE, et al. Beyond recreational physical activity: examining occupational and household activity, transportation activity, and sedentary behavior in relation to postmenopausal breast cancer risk. Am J Public Health. 100(11):2288-95, 2010.
  5. Eliassen AH, Hankinson SE, Rosner B, Holmes MD, Willett WC. Physical activity and risk of breast cancer among postmenopausal women. Arch Intern Med. 170(19):1758-64, 2010.
  6. Tehard B, Friedenreich CM, Oppert JM, Clavel-Chapelon. Effect of physical activity on women at increased risk of breast cancer: results from the E3N cohort study. Cancer Epidemiol Biomarkers Prev. 15(1):57-64, 2006.
  7. Dallal CM, Sullivan-Halley J, Ross RK, et al. Long-term recreational physical activity and risk of invasive and in situ breast cancer: the California teachers study. Arch Intern Med. 167(4):408-15, 2007.
  8. Phipps AI, Chlebowski RT, Prentice R, et al. Body size, physical activity, and risk of triple-negative and estrogen receptor-positive breast cancer. Cancer Epidemiol Biomarkers Prev. 20(3):454-63, 2011.
  9. Bardia A, Hartmann LC, Vachon CM, et al. Recreational physical activity and risk of postmenopausal breast cancer based on hormone receptor status. Arch Intern Med. 166(22):2478-83, 2006
  10. Silvera SAN, Jain M, Howe GR, et al. Energy balance and breast cancer risk: a prospective cohort study. Breast Cancer Res Treat. 97(1):97-106, 2006.
  11. Patel AV, Calle EE, Bernstein L, Wu AH, Thun MJ. Recreational physical activity and risk of postmenopausal breast cancer in a large cohort of US women. Cancer Causes and Control. 14(6):519-29, 2003.
  12. Margolis KL, Mucci L, Braaten T, et al. Physical activity in different periods of life and the risk of breast cancer: the Norwegian-Swedish Women's Lifestyle and Health cohort study. Cancer Epidemiol Biomarkers Prev. 14(1):27-32, 2005. 
  13. Leitzmann MF, Moore SC, Peters TM, et al. Prospective study of physical activity and risk of postmenopausal breast cancer. Breast Cancer Res. 10(5):R92, 2008.
  14. Dirx MJ, Voorrips LE, Goldbohm RA, et al. Baseline recreational physical activity, history of sports participation, and postmenopausal breast carcinoma risk in the Netherlands Cohort Study. Cancer. 92(6):1638-1649, 2001.
  15. Howard RA, Leitzmann MF, Linet MS, Freedman DM. Physical activity and breast cancer risk among pre- and postmenopausal women in the U.S. Radiologic Technologists cohort. Cancer Causes Control. 20(3):323-33, 2009.
  16. Colditz GA, Feskanich D, Chen WY, Hunter DJ, Willett WC. Physical activity and risk of breast cancer in premenopausal women. Br J Cancer. 89(5):847-51, 2003.
  17. Maruti SS, Willett WC, Feskanich D, Rosner B, Colditz GA. A prospective study of age-specific physical activity and premenopausal breast cancer. J Natl Cancer Inst. 100(10):728-37, 2008.
  18. Pronk A, Ji BT, Shu XO, et al. Physical activity and breast cancer risk in Chinese women. Br J Cancer. 105(9):1443-50, 2011.
  19. Chang SC, Ziegler RG, Dunn B, et al. Association of energy intake and energy balance with postmenopausal breast cancer in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev. 15(2):334-41, 2006.
  20. Wu Y, Zhang D, Kang S. Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res Treat. 137(3):869-82, 2013.

Updated 08/31/13