Physical Exercise and the Hallmarks of Breast Cancer: A Narrative Review

Abstract

Growing evidence suggests that, among the different molecular/cellular pathophysiological mechanisms associated with cancer, there are 14 hallmarks that play a major role, including: (i) sustaining proliferative signaling, (ii) evading growth suppressors, (iii) activating invasion and metastasis, (iv) enabling replicative immortality, (v) inducing angiogenesis, (vi) resisting cell death, (vii) reprogramming energy metabolism, (viii) evading immune destruction, (ix) genome instability and mutations, (x) tumor-promoting inflammation, (xi) unlocking phenotypic plasticity, (xii) nonmutational epigenetic reprogramming, (xiii) polymorphic microbiomes, and (xiv) senescent cells. These hallmarks are also associated with the development of breast cancer, which represents the most prevalent tumor type in the world. The present narrative review aims to describe, for the first time, the effects of physical activity/exercise on these hallmarks. In summary, an active lifestyle, and particularly regular physical exercise, provides beneficial effects on all major hallmarks associated with breast cancer, and might therefore help to counteract the progression of the disease or its associated burden.

Potential involvement of neutrophils on exercise effects in breast cancer malignancy

“…Physical activity refers to all body movements related to skeletal muscles through energy expenditure, and physical exercise is a subcategory of planned, structural, and repetitive physical activity to improve or maintain physical strength [ 16 , 17 ]. A dose-response analysis by Dia et al (2023) reported an inverse correlation between physical activity levels and cancer risk [ 18 ] and showed that 150–300 min of moderate-intensity exercise (or 75–150 min of vigorous exercise) per week can reduce the breast cancer risk by 25–30% compared to sedentary adults [ 19 ].…”

“…In general, decreased physical activity, negative changes in body composition, increased tendency toward depression or anxiety, and fatigue may occur during breast cancer treatment [ 17 , 25 , 26 ]. Women diagnosed with breast cancer tend to have reduced physical activity levels, with a much greater decline observed in treated patients than in untreated patients [ 27 ].…”

Breast Cancer Treatment Using the Magneto-Hyperthermia Technique Associated with Omega-3 Polyunsaturated Fatty Acids’ Supplementation and Physical Training

“…It is recognized that leading a healthy lifestyle both lowers the chance of acquiring breast cancer and improves the prognosis for the disease, and that regular exercise has positive impacts on cancer-related traits that can help slow the progression of the disease [ 58 , 59 ]. Physical training improves muscular strength, psychological well-being, and cardiorespiratory fitness.…”

The Mediterranean Lifestyle to Contrast Low-Grade Inflammation Behavior in Cancer

“…Inducing cell proliferation and progression, blocking apoptosis, and promoting angiogenesis are all ways in which estrogens promote breast carcinogenesis [ 32 ]. Several studies have revealed that menopausal women who engage in regular exercise have lower levels of free estrogen in their blood [ 33 , 34 , 35 ]. Exercise has several effects on endogenous estrogen, including weight loss, changes in serum adipokine levels, and a lower circulating insulin concentration [ 36 , 37 ].…”