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Background Exercise training reduces inflammation in breast cancer survivors; however, the mechanism is not fully understood. Objectives The effects of acute and chronic exercise on monocyte toll-like receptor (TLR2 and 4) expression and intracellular cytokine production were examined in sedentary breast cancer survivors. Methods Eleven women with stage I, II, or III breast cancer within one year of treatment completion performed an acute, intermittent aerobic exercise trial. Blood samples were obtained before, immediately, and 1 h after a 45-min acute exercise trial that was performed before and after 16 weeks of combined aerobic and resistance. LPS-stimulated intracellular IL-1ß, TNF, and IL-6 production, and TLR2 and TLR4 expression were evaluated in CD14 + CD16 - and CD14 + CD16 + monocytes using flow cytometry. Results Exercise training decreased IL-1ß + CD14 + CD16 - proportion (24.6%, p=0.016), IL-1ß + CD14 + CD16 - mean fluorescence intensity (MFI) (−9989, p=0.014), IL-1ß + CD14 + CD16 + MFI (−11101, p=0.02), and IL-6 + CD14 + CD16 - proportion (16.9%, P=0.04). TLR2 and TLR4 expression did not change following exercise training but decreased 1 h after acute exercise in CD14 + CD16 - (−63, p=0.002) and CD14 + CD16 + (−18, p=0.006) monocytes, respectively. Immediately after the acute exercise, both monocyte subgroup cell concentration increased, with CD14 + CD16 + concentrations being decreased at 1 h post without changes in intracellular cytokine production. Conclusions Exercise training reduced monocyte intracellular pro-inflammatory cytokine production, especially IL-1ß, although these markers did not change acutely. While acute exercise downregulated the expression of TLR2 and TLR4 on monocytes, this was not sustained over the course of training. These results suggest that the anti-inflammatory effect of combined aerobic and resistance exercise training in breast cancer survivors may be, in part, due to reducing resting monocyte pro-inflammatory cytokine production.

Context:As breast cancer treatment going forward, need for supportive strategies grows. That creates an important call to summarize what has been done regionally.Objectives: In this study, we systematically reviewed articles that proceeded rehabilitation and supportive care in breast cancer patients in Iran to present a research map of rehabilitation research in the past 10 years in Iran.Data Sources: All articles published from January 2006 to October 2015 were included. All of the breast cancer studies in Iran were searched in 3 English (Web of Science, PubMed, and Scopus) and 2 Persian databases (SID and IranMedex).Study Selection: All papers related to rehabilitation in breast cancer were included and categorized into 5 subgroups including qualitative, instrument, lymphedema, interventional, and observational studies. Three reviewers (two surgeons and an epidemiologist) screened the primary search and divided it into subgroups.Data Extraction: Two reviewers used a checklist to critically appraise the full text of the selected articles. The necessary information of retrieved articles was extracted and recorded in the designed data extraction spreadsheet in Excel software.Results: A total of 194 articles (102 in English and 92 in Persian) were assessed for eligibility of inclusion in the review, of which, 121 were excluded, and 73 studies were kept. The included studies consisted of 14 on qualitative design, 5 studies in the translation and validation of research instruments, 7 articles in the field of lymphedema, 20 articles about different intervention modalities on breast cancer patients (including education, social status, psychological, exercise, etc.), and 27 observational studies about anxiety, depression, quality of life, sexual function, emotional distress, complementary medicine, lifestyle, etc.Conclusions: Most of the reviewed studies insisted on a prevalence of physical, psychological, functional, and spiritual problems of breast cancer survivors and their caregivers. Designing a mega project to offer a palliative and rehabilitation service package according to the needs of Iranian patients may become a priority in their health care system.

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