BREAST CANCER (B OVERMOYER, SECTION EDITOR)
Physical Activity and Breast Cancer: an Opportunity
to Improve Outcomes
Lindsay L. Peterson
Jennifer A. Ligibel
Published online: 30 April 2018
Springer Science+Business Media, LLC, part of Springer Nature 2018
Purpose of Review To review current data regarding physical activity and breast cancer including cancer risk, cancer prognosis,
treatment-related side effects, and patient-reported outcomes. We will summarize current physical activity guidelines for cancer
survivors and discuss opportunities to study and implement physical activity programs in cancer survivors.
Recent Findings Observational evidence suggests that physical activity is associated with a reduced risk of developing breast
cancer, a reduced risk of breast cancer recurrence, and improved breast cancer-specific and all-cause mortality. Studies also show
that physical activity improves factors important to quality of life such as chemotherapy-related fatigue and the aromatase
inhibitor-induced musculoskeletal syndrome.
Summary Physical activity is an important component of breast cancer survivorship. Challenges exist in conducting clinical trials
of physical activity and implementing current guidelines, yet there are significant opportunities to advance the field through
translational research efforts and utilization of available community resources.
Breast cancer survivorship
Breast cancer is common not only in the United States (US)
but worldwide. Globally, breast cancer accounts for 1 in 4
cancer diagnoses. Although significant advances in screening
and treatment have led to declining death rates, over 40,000
deaths are attributed to the disease each year in the US alone.
While improved therapies have contributed to declining death
rates, cancer treatments often lead to significant toxicity.
Concomitant with the work to improve cancer treatments,
efforts must also focus on reduction of short- and long-term
side effects of cancer treatments. Non-pharmaceutical strate-
gies such as physical activity are ideal adjuncts to current
breast cancer therapies as they have the potential to improve
both prognosis and quality of life in cancer survivors.
The benefits of physical activity, any movement that results
in energy expenditure, and exercise, planned physical activity
that is performed with the intention of impacting physical
fitness, in the general population have long been known and
include reduced all-cause and cardiovascular mortality [1, 2].
The benefits of physical activity are also becoming apparent in
cancer survivors. Observational data shows a clear and con-
sistent association between higher levels of physical activity
and improvements in breast cancer-specific and overall mor-
tality [3, 4]. High-quality evidence from randomized con-
trolled trials also demonstrates that physical activity can mit-
igate treatment-related side effects such as chemotherapy-
related fatigue [5•, 6] and the aromatase inhibitor-induced
musculoskeletal syndrome [7, 8].
Given the many benefits of physical activity for cancer
survivors, several groups including American Cancer
Society and the National Comprehensive Cancer Network
have developed guidelines that recommend regular physical
activity for cancer survivors [9, 10]. However, despite the
This article is part of the Topical Collection on Breast Cancer
* Lindsay L. Peterson
Jennifer A. Ligibel
Washington University School of Medicine, 660 S Euclid Ave,
Campus Box 8056, St Louis, MO 63110, USA
Harvard Medical School, Boston, MA, USA
Leonard P. Zakim Center for Integrative Therapies and Healthy
Living, Dana Farber Cancer Institute, 450 Brookline Avenue,
Boston, MA 02215, USA
Current Oncology Reports (2018) 20: 50