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The impact of breast cancer on physical activity from midlife to early older adulthood and predictors of change post-diagnosis

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Abstract

Purpose

To examine physical activity (PA) patterns from pre- to post-diagnosis, and compare these changes to women without breast cancer. To determine pre-diagnosis predictors of PA change, post-diagnosis, in breast cancer survivors (BCS).

Methods

Data were from 2314 Study of Women’s Health Across the Nation (SWAN) participants, average age of 46.4 ± 2.7 years at baseline (1996–1997). In Pink SWAN, 151 women who reported an incident breast cancer diagnosis over 20 years were classified as BCS; the remaining 2163 women were controls. LOESS plots and linear mixed models were used to illustrate and compare PA changes (sports/exercise [primary measure] and total PA) from pre- to post-diagnosis (or corresponding period) in BCS versus controls. Adjusted linear regression models were used to determine pre-diagnosis predictors of at-risk post-diagnosis PA change patterns (consistently low and decreased PA).

Results

No differences in pre- to post-diagnosis PA (or corresponding period) were observed in BCS versus controls. Among BCS, the odds of at-risk post-diagnosis PA change patterns was 2.50 (95% CI 0.96–6.48) times higher for those who reported sleep problems at ≥ 50% (compared to 0%) of pre-diagnosis visits and 3.49 (95% CI 1.26–9.65) times higher for those who were overweight or obese at all (compared to no) pre-diagnosis visits. No other statistically significant predictors were noted.

Conclusions

Age-related declines in PA were not amplified by a breast cancer diagnosis. Given the beneficial role of PA across the cancer control continuum, efforts to increase or maintain adequate PA, post-diagnosis, should be continued.

Implications for Cancer Survivors

While age-related physical activity declines were not amplified breast cancer diagnosis, efforts to identify breast cancer survivors at increased risk for post-diagnosis physical activity declines (or maintenance of low activity) may be a high-yield strategy to improve prognosis and quality of life.

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References

  1. American [Internet]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf.

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30.

    Article  PubMed  Google Scholar 

  3. American [Internet]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf.

  4. United [Internet]. Available from: https://seer.cancer.gov/statfacts/html/breast.html.

  5. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26.

  6. Courneya KS, Friedenreich CM. Physical activity and cancer control. Semin Oncol Nurs. 2007;23(4):242–52.

    Article  PubMed  Google Scholar 

  7. United [Internet]. Available from: https://health.gov/paguidelines/pdf/paguide.pdf.

  8. United [Internet]. Available from: https://health.gov/paguidelines/second-edition/report/pdf/PAG_Advisory_Committee_Report.pdf.

  9. Emery CF, Yang HC, Frierson GM, Peterson LJ, Suh S. Determinants of physical activity among women treated for breast cancer in a 5-year longitudinal follow-up investigation. Psychooncology. 2009;18(4):377–86.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Harrison S, Hayes SC, Newman B. Level of physical activity and characteristics associated with change following breast cancer diagnosis and treatment. Psychooncology. 2009;18(4):387–94.

    Article  PubMed  Google Scholar 

  11. Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20(4):1128–43.

    Article  PubMed  Google Scholar 

  12. Hair BY, Hayes S, Tse CK, Bell MB, Olshan AF. Racial differences in physical activity among breast cancer survivors: implications for breast cancer care. Cancer. 2014;120(14):2174–82.

    Article  PubMed  Google Scholar 

  13. Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD, et al. Physical activity levels before and after a diagnosis of breast carcinoma: the health, eating, activity, and lifestyle (HEAL) study. Cancer. 2003;97(7):1746–57.

    Article  PubMed  Google Scholar 

  14. Irwin ML, McTiernan A, Bernstein L, Gilliland FD, Baumgartner R, Baumgartner K, et al. Physical activity levels among breast cancer survivors. Med Sci Sports Exerc. 2004;36(9):1484–91.

    PubMed  PubMed Central  Google Scholar 

  15. Kwan ML, Sternfeld B, Ergas IJ, Timperi AW, Roh JM, Hong CC, et al. Change in physical activity during active treatment in a prospective study of breast cancer survivors. Breast Cancer Res Treat. 2012;131(2):679–90.

    Article  PubMed  Google Scholar 

  16. Brunet J, Amireault S, Chaiton M, Sabiston CM. Identification and prediction of physical activity trajectories in women treated for breast cancer. Ann Epidemiol. 2014;24(11):837–42.

    Article  PubMed  Google Scholar 

  17. Lucas AR, Levine BJ, Avis NE. Posttreatment trajectories of physical activity in breast cancer survivors. Cancer. 2017;123(14):2773–80.

    Article  PubMed  Google Scholar 

  18. Caspersen CJ, Pereira MA, Curran KM. Changes in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc. 2000;32(9):1601–9.

    Article  CAS  PubMed  Google Scholar 

  19. Pettee Gabriel K, Sidney S, Jacobs DR Jr, et al. Ten-year changes in accelerometer-based physical activity and sedentary time during midlife: the CARDIA study. Am J Epidemiol. 2018;187(10):2145–50.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Littman AJ, Tang MT, Rossing MA. Longitudinal study of recreational physical activity in breast cancer survivors. J Cancer Surviv. 2010;4(2):119–27.

    Article  PubMed  Google Scholar 

  21. Sowers MF, Crawford SL, Sternfeld B. A multicenter, multiethnic, community-based cohort study of women and the menopausal transition. In: Lobo RA, Kelsey J, Marcus R, editors. Menopause: biology and pathobiology. San Diego: Academic Press; 2000.

    Google Scholar 

  22. Ainsworth BE, Sternfeld B, Richardson MT, Jackson K. Evaluation of the kaiser physical activity survey in women. Med Sci Sports Exerc. 2000;32(7):1327–38.

    Article  CAS  PubMed  Google Scholar 

  23. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, et al. 2011 compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81.

    Article  PubMed  Google Scholar 

  24. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):S498–504.

    Article  CAS  PubMed  Google Scholar 

  25. Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243–74.

    Article  PubMed  Google Scholar 

  26. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.

    Article  Google Scholar 

  27. Bromberger JT, Kravitz HM, Chang Y, et al. Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation. Menopause. 2013;20(5):488–95.

    PubMed  PubMed Central  Google Scholar 

  28. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.

    Article  CAS  PubMed  Google Scholar 

  29. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–14.

    Article  CAS  PubMed  Google Scholar 

  30. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.

    Article  PubMed  Google Scholar 

  31. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Bmj. 1992;305(6846):160–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Consultation WHOE. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.

    Article  Google Scholar 

  33. Blaney JM, Lowe-Strong A, Rankin-Watt J, Campbell A, Gracey JH. Cancer survivors’ exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire-survey. Psychooncology. 2013;22(1):186–94.

    Article  CAS  PubMed  Google Scholar 

  34. Courneya KS, McKenzie DC, Reid RD, Mackey JR, Gelmon K, Friedenreich CM, et al. Barriers to supervised exercise training in a randomized controlled trial of breast cancer patients receiving chemotherapy. Ann Behav Med. 2008;35(1):116–22.

    Article  PubMed  Google Scholar 

  35. Blaney J, Lowe-Strong A, Rankin J, Campbell A, Allen J, Gracey J. The cancer rehabilitation journey: barriers to and facilitators of exercise among patients with cancer-related fatigue. Phys Ther. 2010;90(8):1135–47.

    Article  PubMed  Google Scholar 

  36. Irwin ML, McTiernan A, Manson JE, Thomson CA, Sternfeld B, Stefanick ML, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the women’s health initiative. Cancer Prev Res. 2011;4(4):522–9.

    Article  Google Scholar 

  37. Borch KB, Braaten T, Lund E, Weiderpass E. Physical activity before and after breast cancer diagnosis and survival - the Norwegian women and cancer cohort study. BMC Cancer. 2015;15:967.

    Article  PubMed  PubMed Central  Google Scholar 

  38. United [Internet]. Available from: https://progressreport.cancer.gov/after/obesity#field_data_source.

  39. Demark-Wahnefried W, Platz EA, Ligibel JA, et al. The role of obesity in cancer survival and recurrence. Cancer Epidemiol Biomark Prev. 2012;21(8):1244–59.

    Article  Google Scholar 

  40. Ligibel JA, Alfano CM, Hershman D, Ballard RM, Bruinooge SS, Courneya KS, et al. Recommendations for obesity clinical trials in cancer survivors: American Society of Clinical Oncology statement. J Clin Oncol. 2015;33(33):3961–7.

    Article  PubMed  Google Scholar 

  41. McTiernan A, Irwin M, Vongruenigen V. Weight, physical activity, diet, and prognosis in breast and gynecologic cancers. J Clin Oncol. 2010;28(26):4074–80.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Caan BJ, Cespedes Feliciano EM, Kroenke CH. The importance of body composition in explaining the overweight paradox in cancer-counterpoint. Cancer Res. 2018;78(8):1906–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Troiano RP, Pettee Gabriel KK, Welk GJ, Owen N, Sternfeld B. Reported physical activity and sedentary behavior: why do you ask? J Phys Act Health. 2012;9(Suppl 1):S68–75.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). Pink SWAN has grant support from the National Cancer Institute (R01 CA199137). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH.

Clinical Centers: University of Michigan, Ann Arbor—Siobán Harlow, PI 2011–present; MaryFran Sowers, PI 1994-2011. Massachusetts General Hospital, Boston, MA—Joel Finkelstein, PI 1999–present; Robert Neer, PI 1994–1999. Rush University, Rush University Medical Center, Chicago, IL—Howard Kravitz, PI 2009–present; Lynda Powell, PI 1994–2009. University of California, Davis/Kaiser—Ellen Gold, PI. University of California, Los Angeles—Gail Greendale, PI. Albert Einstein College of Medicine, Bronx, NY—Carol Derby, PI 2011–present; Rachel Wildman, PI 2010—2011; Nanette Santoro, PI 2004–2010. University of Medicine and Dentistry – New Jersey Medical School, Newark—Gerson Weiss, PI 1994–2004. The University of Pittsburgh, Pittsburgh, PA—Karen Matthews, PI.

NIH Program Office: National Institute on Aging, Bethesda, MD—Chhanda Dutta 2016–present; Winifred Rossi 2012–2016; Sherry Sherman 1994–2012; Marcia Ory 1994–2001; National Institute of Nursing Research, Bethesda, MD – Program Officers.

Central Laboratory: University of Michigan, Ann Arbor—Daniel McConnell (Central Ligand Assay Satellite Services).

Coordinating Center: University of Pittsburgh, Pittsburgh, PA—Maria Mori Brooks, PI 2012–present; Kim Sutton-Tyrrell, PI 2001–2012. New England Research Institutes, Watertown, MA—Sonja McKinlay, PI 1995–2001.

Steering Committee: Susan Johnson, Current Chair

Chris Gallagher, Former Chair

We thank the study staff at each site and all the women who participated in SWAN.

Author information

Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham, RPHB 217, 1720 2nd Ave S, Birmingham, AL, 35294-0022, USA

    Kelley Pettee Gabriel

  2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94610, USA

    Barbara Sternfeld

  3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Alicia B. Colvin

  4. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23219, USA

    Alexander R. Lucas

  5. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA

    Carrie A. Karvonen-Gutierrez

  6. Department of Public Health Sciences, Division of Epidemiology, University of California – Davis, Davis, CA, 95817, USA

    Ellen B. Gold

  7. Graduate School of Nursing, University of Massachusetts Medical School, Worchester, MA, 01605, USA

    Sybil Crawford

  8. Department of Medicine, Division of Geriatrics, University of California Los Angeles, Los Angeles, CA, 90095, USA

    Gail A. Greendale

  9. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA

    Nancy E. Avis

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  1. Kelley Pettee Gabriel
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  2. Barbara Sternfeld
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  7. Sybil Crawford
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Corresponding author

Correspondence to Kelley Pettee Gabriel.

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Conflict of interest

Authors Gabriel, Sternfeld, Colvin, Lucas, Karvonen-Gutierrez, and Crawford declares that they have no conflict of interest. Author Gold received research grant U01AG012554 from the National Institute on Aging. Author Greendale received research grant U01AG012539 from the National Institute on Aging. Author Avis received research grant R01CA199137 from the National Cancer Institute.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Pettee Gabriel, K., Sternfeld, B., Colvin, A.B. et al. The impact of breast cancer on physical activity from midlife to early older adulthood and predictors of change post-diagnosis. J Cancer Surviv 14, 545–555 (2020). https://doi.org/10.1007/s11764-020-00879-7

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  • DOI: https://doi.org/10.1007/s11764-020-00879-7

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