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Evidence summaries

Exercise for Women Receiving Therapy for Breast Cancer

Exercise appears to improve physical fitness in women receiving therapy for breast cancer compared with no exercise. Exercise might slightly improve health related quality of life. Level of evidence: "B"

The quality of evidence is downgraded by study quality (no blinding of outcome assessment, unclear allocation concealment).

A Cochrane review 2 (abstract , review [Abstract]) included 32 trials involving a total of 2626 women. Physical exercise (aerobic or resistance exercise or both) during adjuvant treatment for breast cancer improved physical fitness (SMD 0.42, 95% CI 0.25 to 0.59, 15 trials, n=13100; moderate-quality evidence) and, slightly reduced fatigue (SMD -0.28, 95% CI -0.41 to -0.16; 19 trials; n=1698; moderate-quality evidence) compared to non-exercising control groups. Exercise showed non-significant improvement in cancer site-specific quality of life (MD 4.24, 95% CI -1.81 to 10.29; 4 studies; n=262), and in depression (SMD -0.15, 95% CI -0.30 to 0.01; 5 studies; n=674).

Another Cochrane review 3 (abstract , review [Abstract]) included 63 trials involving a total of 5761 women with breast cancer. Compared to control, physical activity interventions (aerobic exercise and/or resistance training) resulted in small-to-moderate improvements in HRQoL (health related quality of life), emotional function, perceived physical function, anxiety, and cardiorespiratory fitness (table T1). Small improvements sustained for 3 months or longer postintervention in fatigue, cardiorespiratory fitness, and self-reported physical activity.

Physical activity versus control for women with breast cancer after adjuvant therapy (immediate postintervention)

Outcome (follow-up: median 12 weeks)Assumed risk - ControlRisk with intervention - Physical activity (95% CI)No. of participants (studies) Quality of evidence
HRQoL using FACT-G (0 to 104 scale)-2.70 to 2.72 standard deviation units (SD)0.39 SD higher (0.21 to 0.57 higher); FACT-points: 5.9 (3.2 to 8.6) points higher1996 (22) Low
Perceived physical function using FACT-PBW (0 to 28 scale)-2.64 to 1.64 SD0.33 SD higher (0.18 to 0.49 higher); FACT-points: 1.7 (0.9 to 2.5) points higher2129 (25) Moderate
Anxiety using PROMIS (0 to 9 scale)-1.33 to 1.19 SD0.57 SD lower (0.95 to 0.19 lower); PROMIS-points: 1.9 (3.2 to 0.6) points lower326 (7) Very low
Depression using FACT-F (0 to 52 scale)-0.79 to 2.84 SD0.34 SD lower (0.62 to 0.05 lower); FACT-points: 2.8 (4.1 to 1.6) points lower657 (12) Low
Fatigue using FACT-F (0 to 52 scale)-1.83 to 1.69 SD0.32 SD lower (0.47 to 0.18 lower); FACT-points 2.8 (4.1 to 1.6) points lower2020 (26) Moderate
Cardiorespiratory fitness: VO2max (mL/kg/min)0.51 to 3.59 SD0.44 SD higher (0.30 to 0.58 higher); VO2max 2.1 (1.4 to 2.7) mL/kg/min higher1265 (23) Moderate

A meta-analysis 4 assessing home-based walking on cancer-related fatigue included 8 RCTs with a total of 764 patients receiving anticancer treatment. Walking decreased fatigue (SMD=-0.61; 95% CI -0.86 to -0.36; P<.001); walking for a gradually increased duration (SMD=-1.24; 95% CI -2.20 to -0.28; P=.010), and no restrictions on walking intensity (SMD=-1.03; 95% CI, -1.75 to -0.31; P=.005).

    References

    • Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2006 Oct 18;(4):CD005001 [Assessed as up-to-date: 30 March 2015]. [PubMed]
    • Lahart IM, Metsios GS, Nevill AM et al. Physical activity for women with breast cancer after adjuvant therapy. Cochrane Database Syst Rev 2018;(1):CD011292. [PubMed]
    • Yuan Y, Lin L, Zhang N et al. Effects of Home-Based Walking on Cancer-Related Fatigue in Patients With Breast Cancer: A Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2021;():.[PubMed]

Primary/Secondary Keywords