Effect of Exercise on Markers of Inflammation in Breast Cancer Survivors: The Yale Exercise and Survivorship Study

Abstract

Physical activity is associated with improved breast cancer survival, but the underlying mechanisms, possibly including modification of the inflammatory state, are not well understood. We analyzed changes in interleukin (IL)-6, C-reactive protein (CRP), and TNF-α in a randomized controlled trial of exercise in postmenopausal breast cancer survivors. Seventy-five women, recruited through the Yale-New Haven Hospital Tumor Registry, were randomized to either a six-month aerobic exercise intervention or usual care. Correlations were calculated between baseline cytokines, adiposity, and physical activity measures. Generalized linear models were used to assess the effect of exercise on IL-6, CRP, and TNF-α. At baseline, IL-6 and CRP were positively correlated with body fat and body mass index (BMI) and were inversely correlated with daily pedometer steps (P < 0.001). We found no significant effect of exercise on changes in inflammatory marker concentrations between women randomized to exercise versus usual care, though secondary analyses revealed a significant reduction in IL-6 among exercisers who reached 80% of the intervention goal compared with those who did not. Future studies should examine the effect of different types and doses of exercise and weight loss on inflammatory markers in large-scale trials of women diagnosed with breast cancer.

The Effect of Exercise Training on Mediators of Inflammation in Breast Cancer Survivors: A Systematic Review with Meta-analysis

“…For example, simple citation tracking from the systematic review by L€ of and colleagues via Google Scholar identifies two additional trials with further data about the effect of exercise on numerous inflammatory mediators (15,16). Further trials may be identified by rigorous searching.…”

The Effect of Exercise Type on Inflammatory Markers in Obese Survivors With Breast Cancer: Randomized Control Trial

“…The IL-6 expression in breast tissue is associated with the grade of the tumor (10,11). Previous studies have shown that, compared to healthy women, breast cancer survivors have higher amounts of circulating cytokines, a disorder that may persist for up to five years after the diagnosis of cancer (12). Obesity, being overweight and inactivity are among factors that cause mild chronic inflammation and can increase the risk of cardiovascular diseases, breast cancer recurrence and death in breast cancer survivors.…”

“…This risk factor is further highlighted by the fact that the majority of breast cancer survivors are overweight or obese. The combination of being overweight and inactive has been attributed to a quarter of all the cases of cancer (12)(13)(14).…”

The Framingham Risk Score Underestimates the Risk of Cardiovascular Events in the HER2-Positive Breast Cancer Population

“…As in our study, low-risk patients in the Ezaz study still experienced cardiotoxicity, which suggests that even patients at low clinical risk would require monitoring to detect tic. Other tools currently used to evaluate the risk of cardiotoxicity include biomarkers such as cardiac troponin and brain natriuretic peptide 19 , global longitudinal strain imaging using echocardiography 20 , and lifestyle factors 21 . A potential avenue for future research is to determine whether clinical risk scores can be used to modulate the intensity of cardiac imaging and biomarker testing, with monitoring being less frequent in low-risk patients compared with high-risk patients.…”