Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival

• Published in: Breast (Edinburgh) Vol. 44; pp. 144 - 152
• Main Authors: Spei, Maria-Eleni, Samoli, Evangelia, Bravi, Francesca, La Vecchia, Carlo, Bamia, Christina, Benetou, Vassiliki
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-04-2019
• Subjects: Breast cancer; Breast cancer survivors; Meta-analysis; Physical activity; Survival; Systematic review; Systematic review; Breast cancer; Breast cancer survivors; Physical activity; Survival; Meta-analysis
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2019.02.001

To further quantify the association between physical activity (PA) after breast cancer diagnosis and all-cause mortality, breast cancer mortality and/or breast cancer recurrence.
PubMed was searched until November 2017 for observational studies investigating any type of PA in association with total mortality, breast cancer mortality and/or breast cancer recurrence among women with breast cancer diagnosis. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using random-effects models for highest versus lowest categories of PA. Ten studies were included in the meta-analysis. During an average follow-up ranging from 3.5 to 12.7 years there were 23,041 breast cancer survivors, 2,522 deaths from all causes, 841 deaths from breast cancer and 1,398 recurrences/remissions. Compared to women in the lowest recreational PA level (lowest quintile/quartile), women in the highest level had a lower risk of all-cause mortality (HR = 0.58, 95% CIs: 0.45–0.75; 8 studies), of death from breast cancer (HR = 0.60, 95% CIs 0.36–0.99; 5 studies) and a lower, albeit non-significant, risk of recurrence (HR = 0.79, 95% CIs 0.60–1.05; 5 studies). There was evidence of heterogeneity between the studies evaluating recreational PA and total mortality (Ι2 = 52.4%) and even higher for breast cancer mortality (Ι2 = 77.7%) or recurrence (Ι2 = 66.4%).
Highest recreational PA after breast cancer diagnosis was associated with lower all-cause and breast cancer mortality. This finding probably reflects the favorable impact of PA on cardiovascular mortality, and a possible favorable role on breast cancer survival, though reverse causation cannot be excluded.
•Physical activity was associated with survival among breast cancer survivors.•Post-diagnosis physical activity was inversely associated with all-cause mortality.•Post-diagnosis physical activity was inversely associated with breast-cancer mortality.•The inverse association with breast cancer recurrence was consistent but not significant.