Age and the effect of physical activity on breast cancer survival: A systematic review

Fontein, D.B.Y.; Glas, Nienke A. de; Duijm, M.; Bastiaannet, E.; Portielje, Johanneke E.A.; Velde, Cornelis J.H. van de; Liefers, Gerrit‐Jan

doi:10.1016/j.ctrv.2013.03.008

Cited by 40 publications

(35 citation statements)

References 46 publications

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“…Observational evidence shows that a physically active lifestyle after cancer treatment prevents relapse and reduces the risk of all-cause mortality [61]. The optimal exercise regime and timing are uncertain and randomised trials are required to assess the preventive benefits.…”

Section: Resultsmentioning

confidence: 99%

Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

et al. 2013

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IntroductionBreast cancer remains a significant scientific, clinical and societal challenge. This gap analysis has reviewed and critically assessed enduring issues and new challenges emerging from recent research, and proposes strategies for translating solutions into practice.MethodsMore than 100 internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals collaborated to address nine thematic areas: genetics, epigenetics and epidemiology; molecular pathology and cell biology; hormonal influences and endocrine therapy; imaging, detection and screening; current/novel therapies and biomarkers; drug resistance; metastasis, angiogenesis, circulating tumour cells, cancer ‘stem’ cells; risk and prevention; living with and managing breast cancer and its treatment. The groups developed summary papers through an iterative process which, following further appraisal from experts and patients, were melded into this summary account.ResultsThe 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease; (9) developing interventions and support to improve the survivorship experience; (10) a continuing need for clinical material for translational research derived from normal breast, blood, primary, relapsed, metastatic and drug-resistant cancers with expert bioinformatics support to maximise its utility. The proposed infrastructural enablers include enhanced resources to support clinically relevant in vitro and in vivo tumour models; improved access to appropriate, fully annotated clinical samples; extended biomarker discovery, validation and standardisation; and facilitated cross-discipline working.ConclusionsWith resources to conduct further high-quality targeted research focusing on the gaps identified, increased knowledge translating into improved clinical care should be achievable within five years.

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Section: Resultsmentioning

confidence: 99%

Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

et al. 2013

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“…Although we did not observe a significant association between physical activity and breast cancer death or recurrence, many previous studies have demonstrated favorable effects of physical activity on breast cancer-specific survival in breast cancer survivors. 4,6,15 Several mechanisms could explain these contradictory results. First, the Dutch population is, in general, more active than other Western societies, 16 especially in comparison with the United States, where most of the previous studies were performed.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 We have previously reported in a systematic review that physical activity is associated with overall survival and breast cancer-specific survival, with postdiagnosis physical activity being most beneficial for these breast cancer outcomes. 6 However, none of the previous studies reported agespecific outcomes for patients aged 65 years or older, although this older breast cancer population may particularly benefit from physical activity.…”

Section: Introductionmentioning

confidence: 98%

Physical activity and survival of postmenopausal, hormone receptor–positive breast cancer patients: Results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study

Glas

Fontein

Bastiaannet

et al. 2014

Cancer

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BACKGROUND: Physical activity has been related to improved breast cancer outcomes. Especially in the older breast cancer population, physical activity may be important because old age is associated with comorbidities and decreased physical function. The purpose of this study was to investigate the relation between physical activity and overall survival, breast cancer-specific survival, and recurrence in several age groups of postmenopausal breast cancer patients. METHODS: The Tamoxifen Exemestane Adjuvant Multinational Lifestyle study was a side study of the Tamoxifen Exemestane Adjuvant Multinational trial and prospectively investigated lifestyle habits of postmenopausal, hormone receptor-positive breast cancer patients. The relations between prediagnosis and postdiagnosis physical activity and overall survival, breast cancer-specific survival, and recurrence-free survival were assessed with Cox regression and competing risk regression models. RESULTS: Among 521 patients, high levels of physical activity before and after the diagnosis were associated with better overall survival (the multivariate hazard ratios were 0.50 [95% confidence interval 5 0.26-0.98] and 0.57 (95% confidence interval 5 0.26-1.40] for patients who were very active before and after the diagnosis, respectively, in comparison with inactive patients). This was most evident in patients who were 65 years old or older. Physical activity was not significantly associated with breast cancer-specific survival or the relapse-free period. CONCLUSIONS: Overall survival was better for patients who were active before and after the diagnosis. In contrast with previous studies, breast cancer survival and the risk of recurrence were not significantly associated with physical activity. These findings confirmed the need for more studies investigating the use of physical activity to supplement breast cancer treatment in older patients. Cancer 2014;120:2847-54.

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“…It should also be noted that a steadily increasing proportion of women diagnosed with breast cancer is expected to be at an advanced age [4,5]. We can therefore well expect an increase in the number of women after mastectomy pursuing predominantly sedentary lifestyle.…”

Section: Introductionmentioning

confidence: 99%

Identifying predictive motor factors for falls in post-menopausal breast cancer survivors

Žák

Biskup

Macek³

et al. 2017

PLoS ONE

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ObjectiveBreast cancer treatment, including radical surgery, is also pursued as late as the 7th - 8th decade of women’s lives. Standard physical rehabilitation procedures offered to those women are predominantly focused on attenuating specific functional deficits of the upper limb and trunk. Seldom do they entail any regimens specifically aimed at recovering overall functionality, and reducing exposure to falls-risk.The study aimed to assess potential interrelationships between the self-reported falls, individual functional capabilities and appreciably reducing exposure to falls-risk in a group of post-menopausal, post-surgical breast cancer survivors.MethodsThe study recruited 102 women (aged 65–79; mean age 70.2), post-surgical breast cancer survivors. The subjects were stratified by age into three groups: Group 1 (65–69 years); Group 2 (70–74 years), and Group 3 (75–79 years). Individual functional capabilities were assessed with Eight-foot up & go test (8UG), chair stand test (CST), and 2-minute step test (2ST). Tinetti POMA test was applied to assess gait and balance disorders. Self-reported falls in the past year were ascertained through a questionnaire.ResultsAssessment of individual aerobic endurance (2ST) also demonstrated a clear deficit in the mean scores category in all respective age sub-groups, as compared against the reference values. The deficits ranged from 4.86 to 15.90 steps less than the normative values; the oldest subjects demonstrating the largest deficit. The aerobic endurance tests results significantly impacted the ultimate assessment of an individual falls-risk in the oldest group. The analysis of the number of falls sustained within the recent year indicated that 43.67% of the subjects fell victim of such incidents.ConclusionAn individual exposure to falls-risk was found to be appreciably more dependent upon individual aerobic endurance rather than overall strength of the lower part of the body in the breast cancer survivors over 75.

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Age and the effect of physical activity on breast cancer survival: A systematic review

Cited by 40 publications

References 46 publications

Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

Physical activity and survival of postmenopausal, hormone receptor–positive breast cancer patients: Results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study

Identifying predictive motor factors for falls in post-menopausal breast cancer survivors

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