Physical Activity Levels Among Breast Cancer Survivors

Melinda L. Irwin; Anne Mctiernan; Leslie Bernstein; Frank D. Gilliland; Richard Baumgartner; Kathy Baumgartner; Rachel Ballard-Barbash

Disclosures

Med Sci Sports Exerc. 2004;36(9) 

In This Article

Abstract and Introduction

Introduction: Obesity and weight gain are negative prognostic factors for breast cancer survival. Physical activity (PA) prevents weight gain and may decrease obesity. Little information exists on PA levels among cancer survivors. We assessed PA, including the proportion of breast cancer survivors engaging in recommended levels, by categories of adiposity, age, disease stage, and ethnicity in 806 women with stage 0-IIIA breast cancer participating in the Health, Eating, Activity, and Lifestyle Study.
Methods: Black, non-Hispanic white, and Hispanic breast cancer survivors were recruited into the study through Surveillance Epidemiology End Results registries in New Mexico, Western Washington, and Los Angeles County, CA. Types of sports and household activities and their frequency and duration within the third yr after diagnosis were assessed during an in-person interview.
Results: Thirty-two percent of breast cancer survivors participated in recommended levels of PA defined as 150 min·wk-1 of moderate- to vigorous-intensity sports/recreational PA. When moderate-intensity household and gardening activities were included in the definition, 73% met the recommended level of PA. Fewer obese breast cancer survivors met the recommendation than overweight and lean breast cancer survivors (P < 0.05). Fewer black breast cancer survivors met the recommendation compared with non-Hispanic white and Hispanic breast cancer survivors (P < 0.05).
Conclusions: Most of the breast cancer survivors were not meeting the PA recommendations proposed for the general adult population. Efforts to encourage and facilitate PA among these women would be an important tool to decrease obesity, prevent postdiagnosis weight gain, and improve breast cancer prognosis.

Epidemiologic studies have linked obesity and low levels of physical activity with an increased risk of breast cancer.[4,21] Clinical and epidemiologic studies have also identified obesity and weight gain as important negative prognostic factors for survival among women with this disease.[7] Physical activity has been associated with weight loss and weight maintenance among healthy individuals,[14,23] and recent studies have shown a favorable effect of exercise on body weight among breast cancer survivors.[12,20] Despite the evidence suggesting that regular physical activity can protect against weight gain, decrease breast cancer risk, and potentially improve breast cancer prognosis, efforts to encourage physical activity are not a routine part of the cancer treatment or rehabilitation process.

Recently, we reported that women diagnosed with breast cancer, who participated in the Health, Eating, Activity, and Lifestyle (HEAL) Study, were significantly less physically active within their first year after diagnosis than they were 1 yr before diagnosis.[13] Obese women reported the most significant declines in physical activity after diagnosis compared with lean women. In designing physical activity programs and interventions for cancer survivors, information on types and intensities of physical activity preferred by cancer survivors is needed.

This analysis examines physical activity levels within the third year after diagnosis in 806 breast cancer survivors enrolled in the HEAL Study, a population-based prospective cohort study. We also examined the influence of obesity, age, stage of disease, and ethnicity on various types and intensities of physical activity, and the proportion of breast cancer survivors participating in physical activity levels recommended by the Surgeon General[22] for the general adult population. To our knowledge, this paper provides the most in depth examination of physical activity levels among cancer survivors to date.

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