The Effect of Aerobic Exercise on Breast Cancer Outcomes: A Comprehensive Review of Available Evidence, Mechanisms, and Methods
The effect of aerobic exercise on breast cancer
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This comprehensive review explores the effects of aerobic exercise on breast cancer outcomes, synthesizing available evidence, underlying mechanisms, and methodological approaches. Breast cancer remains a significant global health concern, and growing research suggests that aerobic exercise may play a crucial role in prevention, treatment, and survivorship. We examined a broad range of studies, including randomized controlled trials (RCTs), systematic reviews, and meta-analyses, to evaluate the impact of aerobic exercise on various breast cancer-related outcomes. The evidence indicates that aerobic exercise interventions can positively influence multiple aspects of breast cancer care. These benefits include improvements in cardiorespiratory fitness, body composition, cancer-related fatigue, quality of life (QOL), and psychological well-being. Additionally, aerobic exercise has shown potential in modulating biomarkers associated with breast cancer risk and progression, such as insulin-like growth factors and inflammatory markers. Mechanistically, aerobic exercise appears to exert its effects through multiple pathways, including modulation of hormonal profiles, enhancement of immune function, reduction of oxidative stress, and alteration of the tumor microenvironment. The physiological adaptations induced by aerobic exercise may also contribute to improved treatment tolerance and reduced therapy-related side effects. Methodologically, studies have employed various aerobic exercise protocols, differing in intensity, duration, and frequency. Recent research has also explored the potential benefits of combined aerobic and resistance training programs. While the optimal exercise prescription remains to be determined, evidence suggests that even moderate levels of aerobic activity can yield significant benefits for breast cancer patients and survivors. This review highlights the multifaceted role of aerobic exercise in breast cancer care, from prevention to survivorship. It also identifies areas requiring further investigation, including the long-term effects of exercise interventions and the potential for personalized exercise prescriptions based on individual patient characteristics and cancer subtypes. As research in this field continues to evolve, integrating aerobic exercise into comprehensive breast cancer care strategies holds promise for improving outcomes and enhancing the overall well-being of those affected by this disease.
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Al-Mhanna, S. B., Batrakoulis, A., Norhayati, M. N., Mohamed, M., Drenowatz, C., Irekeola, A. A., & Ghazali, W. S. W. (2024). Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Sports Science & Medicine, 23(2), 366.
Bender, C. M., Sereika, S. M., Gentry, A. L., Cuglewski, C., Duquette, J., Grove, G., & Erickson, K. (2024). Effects of aerobic exercise on neurocognitive function in postmenopausal women receiving endocrine therapy for breast cancer: The Exercise Program in Cancer and Cognition randomized controlled trial. Psycho‐Oncology, 33(2), e6298.
Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., ... & Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise, 51(11), 2375-2390.
Cerulli, C., Moretti, E., Grazioli, E., Emerenziani, G. P., Murri, A., Tranchita, E., & Parisi, A. (2024). Protective role of exercise on breast cancer-related osteoporosis in women undergoing aromatase inhibitors: A narrative review. Bone Reports, 101756.
Cheng L, Tian W, Mu H. Effects of aerobic combined with resistance exercise on cardiorespiratory fitness and cardiometabolic health in breast cancer survivors: A Systematic Review, meta-analysis and meta-regression. Heliyon. 2024;10(4):e26318.
Courneya, K. S., Segal, R. J., Mackey, J. R., Gelmon, K., Reid, R. D., Friedenreich, C. M., ... & McKenzie, D. C. (2007). Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Journal of Clinical Oncology, 25(28), 4396-4404.
Courneya, K. S., Segal, R. J., Mackey, J. R., Gelmon, K., Reid, R. D., Friedenreich, C. M., & McKenzie, D. C. (2015). Effects of aerobic and resistance exercise in breast cancer patients.
Dai, Y., Chen, J., Fang, Y., Yang, W., Hu, M., & He, F. (2024). Effects of Aerobic Exercise on Sleep Disorder of Breast Cancer Patients: A Systemic Review. Academic Journal of Medicine & Health Sciences, 5(4), 71-75.
Dolan, L. B., Campbell, K., Gelmon, K., Neil-Sztramko, S., Holmes, D., & McKenzie, D. C. (2016). Interval versus continuous aerobic exercise training in breast cancer survivors-a pilot RCT. Supportive Care in Cancer, 24, 119-127.
Drouin, J. S., Armstrong, H., Krause, S., Orr, J., Birk, T. J., Hryniuk, W. M., & Hryniuk, L. E. (2005). Effects of aerobic exercise training on peak aerobic capacity, fatigue, and psychological factors during radiation for breast cancer. Rehabilitation Oncology, 23(1), 11-17.
Haley, J. S., Hibler, E. A., Zhou, S., Schmitz, K. H., & Sturgeon, K. M. (2020). Dose‐dependent effect of aerobic exercise on inflammatory biomarkers in a randomized controlled trial of women at high risk of breast cancer. Cancer, 126(2), 329-336.
Holick, C. N., Newcomb, P. A., Trentham-Dietz, A., Titus-Ernstoff, L., Bersch, A. J., Stampfer, M. J., ... & Willett, W. C. (2008). Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiology Biomarkers & Prevention, 17(2), 379-386.
Irwin, M. L., Varma, K., Alvarez-Reeves, M., Cadmus, L., Wiley, A., Chung, G. G., & Yu, H. (2009). Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study. Cancer Epidemiology Biomarkers & Prevention, 18(1), 306-313.
Jones, A. M., Burnley, M., & Vanhatalo, A. (2018). Aerobic exercise performance. In Kinanthropometry and Exercise Physiology (pp. 318-352). New York, NY: Routledge.
Jones, L. W., Viglianti, B. L., Tashjian, J. A., Kothadia, S. M., Keir, S. T., Freedland, S. J., & Dewhirst, M. W. (2010). Effect of aerobic exercise on tumor physiology in an animal model of human breast cancer. Journal of Applied Physiology, 108(2), 343-348.
Kirkham, A. A., Bonsignore, A., Bland, K. A., McKenzie, D. C., Gelmon, K. A., Van Patten, C. L., & Campbell, K. L. (2018). Exercise prescription and adherence for breast cancer: one size does not FITT all. Medicine and Science in Sports and Exercise, 50(2), 177-186.
Koelwyn, G. J., Quail, D. F., Zhang, X., White, R. M., & Jones, L. W. (2017). Exercise-dependent regulation of the tumour microenvironment. Nature Reviews Cancer, 17(10), 620-632.Lian, Y., Sandhu, S., Asefa, Y., & Gupta, A. (2024). The Effect of Exercise on Reducing Lymphedema Severity in Breast Cancer Survivors. Cancers, 16(7), 1367.
Linhares, B. G., Linhares, D. G., Boppre, G., & Zacca, R. (2024). New Insights Into Cardioprotection In Breast Cancer Patients Undergoing Physical Exercise During Chemotherapy: A Systematic Review And Meta-Analysis. Current Problems In Cardiology, 102743.
McNeely, M. L., Campbell, K. L., Rowe, B. H., Klassen, T. P., Mackey, J. R., & Courneya, K. S. (2006). Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ, 175(1), 34-41.
Millstein, R. (2020). Aerobic exercise. In Encyclopedia of Behavioral Medicine (pp. 61-62). Cham: Springer International Publishing.
Milne, H. M., Wallman, K. E., Gordon, S., & Courneya, K. S. (2008). Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial. Breast Cancer Research and Treatment, 108, 279-288.
Moulton, C., Grazioli, E., Ibáñez-Cabellos, J. S., Murri, A., Cerulli, C., Silvestri, M., & Dimauro, I. (2024). Physical Activity and Epigenetic Aging in Breast Cancer Treatment. International Journal of Molecular Sciences, 25(16), 8596.
Patel, J. G., & Bhise, A. R. (2017). Effect of aerobic exercise on cancer-related fatigue. Indian Journal of Palliative Care, 23(4), 355.
Pinto, B. M., Stein, K., & Dunsiger, S. (2020). Peer mentoring to promote physical activity among cancer survivors: effects on quality of life. Psycho‐Oncology, 29(3), 552-559.
Pollak, M. (1998). IGF-I physiology and breast cancer. Adjuvant Therapy of Primary Breast Cancer VI, 63-70.
receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Journal of Clinical Oncology, 33(13), 1485-1492.
Rock, C. L., Thomson, C., Gansler, T., Gapstur, S. M., McCullough, M. L., Patel, A. V., ... & Doyle, C. (2020). American Cancer Society guideline for diet and physical activity for cancer prevention. CA: A Cancer Journal for Clinicians, 70(4), 245-271.
Santa Mina, D., Sabiston, C. M., Au, D., Fong, A. J., Capozzi, L. C., Langelier, D., & Alibhai, S. M. (2018). Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement. Current Oncology, 25(2), 149-162.
Schmitz, C. M., Wang, Q., Yasui, Y., Stanczyk, F. Z., Duha, A., Brenner, D. R., & Courneya, K. S. (2019). Long-term effects of moderate versus high durations of aerobic exercise on biomarkers of breast cancer risk: follow-up to a randomized controlled trial. Cancer Epidemiology, Biomarkers & Prevention, 28(10), 1725-1734.
Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., ... & Matthews, C. E. (2020). Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA: A Cancer Journal for Clinicians, 70(4), 254-279.
Schmitz, K. H., Williams, N. I., Kontos, D., Domchek, S., Morales, K. H., Hwang, W. T., & Good, J. (2015). Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer: a randomized controlled trial. Breast cancer research and treatment, 154, 309-318.
Scott, J. M., Jones, L. W., Hornsby, W. E., Koelwyn, G. J., Khouri, M. G., Joy, A. A., & Lakoski, S. G. (2014). Cancer therapy-induced autonomic dysfunction in early breast cancer: implications for aerobic exercise training. International journal of cardiology, 171(2), e50.
Scott, J. M., Khakoo, A., Mackey, J. R., Haykowsky, M. J., Douglas, P. S., & Jones, L. W. (2011). Modulation of anthracycline-induced cardiotoxicity by aerobic exercise in breast cancer: current evidence and underlying mechanisms. Circulation, 124(5), 642-650.
Segal, R., Zwaal, C., Green, E., Tomasone, J. R., Loblaw, A., & Petrella, T. (2017). Exercise for people with cancer: a clinical practice guideline. Current Oncology, 24(1), 40-46.
Segar, M. L., Katch, V. L., Roth, R. S., Garcia, A. W., Portner, T. I., Glickman, S. G., & Wilkins, E. G. (1998, January). The effect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors. In Oncology Nursing Forum, 25(1), 107-113).
Shobeiri, F., Masoumi, S. Z., Nikravesh, A., Moghadam, R. H., & Karami, M. (2016). The impact of aerobic exercise on quality of life in women with breast cancer: a randomized controlled trial. Journal of Research in Health Sciences, 16(3), 127.
Sitjar, P. H. S., Tan, S. Y., Wong, M., Li, J., Jalil, R. B. A., Aw, H., & Goh, J. (2024). Combined aerobic and strength exercise training on biological ageing in Singaporean breast cancer patients: protocol for the Breast Cancer Exercise Intervention (BREXINT) Pilot Study. GeroScience, 1-10.
Soriano-Maldonado, A., Carrera-Ruiz, Á., Díez-Fernández, D. M., Esteban-Simón, A., Maldonado-Quesada, M., Moreno-Poza, N., ... & Casimiro-Andujar, A. J. (2019). Effects of a 12-week resistance and aerobic exercise program on muscular strength and quality of life in breast cancer survivors: Study protocol for the EFICAN randomized controlled trial. Medicine, 98(44), e17625.
Wurz, A., St-Aubin, A., & Brunet, J. (2016). Breast cancer survivors' barriers and motives for participating in a group-based physical activity program offered in the community. Supportive Care in Cancer, 24(8), 3361-3369.
Yang, T. Y., Chen, M. L., & Li, C. C. (2015). Effects of an aerobic exercise programme on fatigue for patients with breast cancer undergoing radiotherapy. Journal of Clinical Nursing, 24(1-2), 202-211.
Zhao, F. Y., Liu, J. E., Fang, X. M., Chen, L., Liang, J. G., Liu, Y., & Chen, H. R. (2024). Effects of a 12-week exercise-based intervention on weight management in overweight or obese breast cancer survivors: a randomized controlled trial. Supportive Care in Cancer, 32(2), 98.
Zhou, R., Chen, Z., Zhang, S., Wang, Y., Zhang, C., Lv, Y., & Yu, L. (2024). Effects of Exercise on Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Life, 14(8), 1011.
Zou, L. Y., Yang, L., He, X. L., Sun, M., & Xu, J. J. (2014). Effects of aerobic exercise on cancer-related fatigue in breast cancer patients receiving chemotherapy: a meta-analysis. Tumor Biology, 35, 5659-5667.
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