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Does obesity modify the relationship between physical activity and breast cancer risk?

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Abstract

Purpose

With only 5–10% of breast cancer cases attributed to genetic inheritance, prevention efforts have focused on modifiable risk factors. Physical activity plays a role in reducing breast cancer risk; however, the interaction between physical activity and other modifiable risk factors, such as obesity, has received little attention.

Methods

A systematic review and meta-analysis was conducted of studies examining the relationship between physical activity and breast cancer and how it may be modified by body mass index (BMI).

Results

A total of 29 papers were included: 18 were cohort and 11 were case–control studies. Overall, a significant reduction in the relative risk of breast cancer was found in postmenopausal women with high versus low levels of physical activity for women with a BMI <25 kg/m2 (RR 0.85, 95% CI 0.79, 0.92) and ≥25 kg/m2 (RR 0.87, 95% CI 0.81, 0.93) but not ≥30 kg/m2 (RR: 0.93, 95% CI 0.76, 1.13). Physical activity was not associated with a significant reduction in risk of breast cancer in premenopausal women in any BMI group.

Conclusion

The results of this meta-analysis suggest that physical activity is associated with a larger breast cancer risk reduction among women who are normal weight or overweight than among women who are obese. Since the included studies used diverse methods for assessment of physical activity and categories of BMI, results should be interpreted with caution and additional work is needed.

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Acknowledgements

The authors would like to acknowledge the Canadian Breast Cancer Foundation BC/Yukon for stimulating discussion that led to this paper.

Funding

SENS was supported by a Canadian Graduate Scholarship Doctoral Award (#290987) and Postdoctoral Fellowship from the Canadian Institutes of Health Research (#358914). SFN and EM were supported by the Faculty of Medicine Summer Student Research Program at the University of British Columbia. TB was supported by the Canadian Institutes of Health Research (Fellowship #300068), the Michael Smith Foundation for Health Research (Postdoctoral Fellowship #5553), Killam Trusts (Honorary Postdoctoral Research Fellowship), and the Australian National Health and Medical Research Council (Early Career Fellowship #1072266).

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

    S. E. Neil-Sztramko

  2. School of Public Health, Curtin University, Perth, Australia

    T. Boyle

  3. Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada

    T. Boyle

  4. School of Kinesiology, University of British Columbia, Vancouver, BC, Canada

    E. Milosevic

  5. MD Undergraduate Program, University of British Columbia, Vancouver, BC, Canada

    S. F. Nugent

  6. Centre of Excellence in Cancer Prevention, University of British Columbia, Vancouver, BC, Canada

    C. C. Gotay

  7. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    C. C. Gotay

  8. Department of Physical Therapy, University of British Columbia, 212, Friedman Building, 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada

    K. L. Campbell

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  1. S. E. Neil-Sztramko
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  2. T. Boyle
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  3. E. Milosevic
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  4. S. F. Nugent
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  5. C. C. Gotay
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  6. K. L. Campbell
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Corresponding author

Correspondence to K. L. Campbell.

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Conflict of interest

All authors declare they have no conflicts of interest to report.

Ethical approval

This article does not contain any studies with human participant performed by any of the authors; included studies in this review report on their accordance with ethical standards individually.

Appendix

Appendix

Physical activity

Physical fitness.mp. or exp Physical Fitness/or exp Physical Exertion/or exertion.mp. or physical endurance.mp. or exp Physical Endurance/or exp Walking/or walking.mp. or recreational activit*.mp. or household activit*.mp. or occupational activit*.mp or physical.

Inactivit*.mp. or physical activit*.mp. or exercise.mp. or exercising.mp. or energy intake.mp. or energy expenditure.mp. or energy balance.mp. or energy density.mp.

Breast cancer

Breast neoplasms.mp. or exp Breast Neoplasms/or (breast and (cancer* or neoplasm* or tumour* or tumor* or carcinoma* or adenocarcinoma*)).mp. or (mammary and (cancer* or neoplasm* or tumour* or tumor* or carcinoma* or adenocarcinoma*)).mp.

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Neil-Sztramko, S.E., Boyle, T., Milosevic, E. et al. Does obesity modify the relationship between physical activity and breast cancer risk?. Breast Cancer Res Treat 166, 367–381 (2017). https://doi.org/10.1007/s10549-017-4449-4

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  • DOI: https://doi.org/10.1007/s10549-017-4449-4

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