Skip to main content

Advertisement

SpringerLink
Log in

Associations between health-related fitness and quality of life in newly diagnosed breast cancer patients

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Newly diagnosed breast cancer patients face substantial stress and uncertainty that may undermine their quality of life (QoL). The purpose of the present study was to examine the associations between health-related fitness (HRF) and QoL in newly diagnosed breast cancer patients from the Alberta Moving Beyond Breast Cancer Study.

Methods

Newly diagnosed breast cancer patients with early-stage disease (n = 1458) were recruited between 2012 and 2019 in Edmonton and Calgary, Canada to complete baseline HRF and QoL assessments within 90 days of diagnosis. HRF assessments included cardiorespiratory fitness (VO2peak treadmill test), muscular fitness (upper and lower body strength and endurance tests), and body composition (dual x-ray absorptiometry). QoL was assessed by the Medical Outcomes Study Short Form 36 (SF-36) version 2. We used logistic regression analyses to examine the associations between quartiles of HRF and poor/fair QoL (bottom 20%) after adjusting for key covariates.

Results

In multivariable analysis, the least fit groups compared to the most fit groups for relative upper body strength (OR = 3.19; 95% CI = 1.98–5.14), lean mass percentage (OR = 2.31; 95% CI = 1.37–3.89), and relative VO2peak (OR = 2.08; 95% CI = 1.21–3.57) were independently at a significantly higher risk of poor/fair physical QoL. No meaningful associations were found for mental QoL.

Conclusions

The three main components of HRF (muscular fitness, cardiorespiratory fitness, and body composition) were independently associated with physical QoL in newly diagnosed breast cancer patients. Exercise interventions designed to improve these components of HRF may optimize physical QoL and help newly diagnosed breast cancer patients better prepare for treatments and recovery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

References

  1. Brenner DR, Poirier A, Woods RR, Ellison LF, Billette JM, Demers AA, Zhang SX, Yao C, Finley C, Fitzgerald N, Saint-Jacques N, Shack L, Turner D, Holmes E; Canadian Cancer Statistics Advisory Committee (2022) Projected estimates of cancer in Canada in 2022. CMAJ 2022 May 2; 194(17):E601–7. https://doi.org/10.1503/cmaj.212097

  2. Siegel RL, Miller KD, Wagle NS, Jemal A (2023) Cancer statistics, 2023. CA Cancer J Clin 2023; 73:17–48.

  3. Montgomery M, McCrone SH (2010) Psychological distress associated with the diagnostic phase for suspected breast cancer: systematic review. J Adv Nurs 66(11):2372–2390

    Article  PubMed  Google Scholar 

  4. Mai TTX, Choi JH, Lee MK, Chang YJ, Jung SY, Cho H, Lee ES (2019) Prognostic value of post-diagnosis health-related quality of life for overall survival in breast cancer: findings from a 10-year prospective cohort in Korea. Cancer Res Treat 51(4):1600–1611

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Quinten C, Coens C, Mauer M, Comte S, Sprangers MA, Cleeland C, Osoba D, Bjordal K, Bottomley A, Groups EC (2009) Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol 10(9):865–871

    Article  PubMed  Google Scholar 

  6. Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD (2018) The physical activity guidelines for Americans. JAMA 320 (19):2020–2028

  7. Hanna L, Nguo K, Furness K, Porter J, Huggins CE (2022) Association between skeletal muscle mass and quality of life in adults with cancer: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 13(2):839–857

    Article  PubMed  PubMed Central  Google Scholar 

  8. Smits A, Lopes A, Bekkers R, Galaal K (2015) Body mass index and the quality of life of endometrial cancer survivors–a systematic review and meta-analysis. Gynecol Oncol 137(1):180–187

    Article  PubMed  Google Scholar 

  9. Campos E, Silva AC, Bergmann A, Araujo CM, Montenegro AKS, Tenorio ADS, Dantas D (2022) Association of handgrip strength with quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pac J Cancer Prev 23(10):3237–3245

    Article  Google Scholar 

  10. Bortolozo HI, Derchain S, Vechin FC, Maginador GF, Santos IS, Torresan R, de Nazare Silva Dos Santos P, Sarian LO, Conceicao MS (2021) Aerobic fitness is a predictor of body composition in women with breast cancer at diagnosis. Clin Breast Cancer 21(3):e245–e251

    Article  PubMed  Google Scholar 

  11. Courneya KS, Vallance JK, Culos-Reed SN, McNeely ML, Bell GJ, Mackey JR, Yasui Y, Yuan Y, Matthews CE, Lau DC et al (2012) The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors. BMC Cancer 12:525

    Article  PubMed  PubMed Central  Google Scholar 

  12. Courneya KS, McNeely ML, Culos-Reed SN, Vallance JK, Bell GJ, Mackey JR, Matthews CE, Morielli AR, Cook D, MacLaughlin S et al (2016) The Alberta moving beyond breast cancer (AMBER) cohort study: recruitment, baseline assessment, and description of the first 500 participants. BMC Cancer 16:481

    Article  PubMed  PubMed Central  Google Scholar 

  13. Friedenreich CM, Vallance JK, McNeely ML, Culos-Reed SN, Matthews CE, Bell GJ, Mackey JR, Kopciuk KA, Dickau L, Wang Q et al (2022) The Alberta moving beyond breast cancer (AMBER) cohort study: baseline description of the full cohort. Cancer Causes Control 33(3):441–453

    Article  PubMed  PubMed Central  Google Scholar 

  14. Maruish M (2011) User’s Manual for the SF36v2 Health Survey. 3rd ed. Quality Metric Incorporated, RI, US

  15. Ware JKM, Dewey J (2000) How to score version two of the SF-36® health survey. Spine. https://doi.org/10.1097/00007632-200012150-00008

    Article  PubMed  Google Scholar 

  16. Csizmadi I, Kahle L, Ullman R, Dawe U, Zimmerman TP, Friedenreich CM, Bryant H, Subar AF (2007) Adaptation and evaluation of the national cancer institute’s diet history questionnaire and nutrient database for Canadian populations. Public Health Nutr 10(1):88–96

    Article  PubMed  Google Scholar 

  17. van Buuren S, Groothuis-Oudshoorn K (2011) Mice: multivariate imputation by chained equations in R. J Stat Softw 45(3):1–67

    Article  Google Scholar 

  18. Vallance JK, Friedenreich CM, Wang Q, Matthews CE, Yang L, McNeely ML, Culos-Reed SN, Bell GJ, Morielli AR, McNeil J et al (2023) Associations of device-measured physical activity and sedentary time with quality of life and fatigue in newly diagnosed breast cancer patients: baseline results from the AMBER cohort study. Cancer 129(2):296–306

    Article  CAS  PubMed  Google Scholar 

  19. Streiner DL, Norman GR (2012) Mine is bigger than yours: measures of effect size in research. Chest 141(3):595–598

    Article  PubMed  Google Scholar 

  20. Buyukakincak O, Akyol Y, Ozen N, Ulus Y, Canturk F, Tander B, Buyukakincak S, Bilgici A, Kuru O (2014) Quality of life in patients with breast cancer at early postoperative period: relationship to shoulder pain, handgrip strength, disability, and emotional status. Turk J Phys Med Rehab 60:1–6

    Article  Google Scholar 

  21. Herrero F, Balmer J, San Juan AF, Foster C, Fleck SJ, Perez M, Canete S, Earnest CP, Lucia A (2006) Is cardiorespiratory fitness related to quality of life in survivors of breast cancer? J Strength Cond Res 20(3):535–540

    PubMed  Google Scholar 

  22. Kim DY, Kim JH, Park SW (2019) Aerobic capacity correlates with health-related quality of life after breast cancer surgery. Eur J Cancer Care (Engl) 28(4):e13050

    Article  PubMed  Google Scholar 

  23. Tolentino GP, Battaglini CL, Araujo SS, Otano AS, Conde DM, Evans ES, de Oliveira RJ (2010) Cardiorespiratory fitness and quality-of-life analysis posttreatment in breast cancer survivors. J Psychosoc Oncol 28(4):381–398

    Article  PubMed  Google Scholar 

  24. Aleixo GFP, Deal AM, Nyrop KA, Muss HB, Damone EM, Williams GR, Yu H, Shachar SS (2020) Association of body composition with function in women with early breast cancer. Breast Cancer Res Treat 181(2):411–421

    Article  CAS  PubMed  Google Scholar 

  25. Aune D, Markozannes G, Abar L, Balducci K, Cariolou M, Nanu N, Vieira R, Anifowoshe YO, Greenwood DC, Clinton SK et al (2022) Physical activity and health-related quality of life in women with breast cancer: a meta-analysis. JNCI Cancer Spectr. https://doi.org/10.1093/jncics/pkac072

    Article  PubMed  PubMed Central  Google Scholar 

  26. Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS (2003) Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol 21(9):1660–1668

    Article  PubMed  Google Scholar 

  27. Courneya KS, Sellar CM, Stevinson C, McNeely ML, Peddle CJ, Friedenreich CM, Tankel K, Basi S, Chua N, Mazurek A et al (2009) Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol 27(27):4605–4612

    Article  PubMed  Google Scholar 

  28. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V (2017) Exercise and mental health. Maturitas 106:48–56

    Article  PubMed  Google Scholar 

  29. An KY, Morielli AR, Kang DW, Friedenreich CM, McKenzie DC, Gelmon K, Mackey JR, Reid RD, Courneya KS (2020) Effects of exercise dose and type during breast cancer chemotherapy on longer-term patient-reported outcomes and health-related fitness: a randomized controlled trial. Int J Cancer 146(1):150–160

    Article  CAS  PubMed  Google Scholar 

  30. Courneya KS, McKenzie DC, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Cook D, Jespersen D, Proulx C et al (2013) Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial. J Natl Cancer Inst 105(23):1821–1832

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded by a Team Grant (#107534), a Project Grant (#155952), and a Foundation Grant (#159927) from the Canadian Institutes of Health Research. KSC and JKV are supported by the Canada Research Chairs Program. CMF was supported by an Alberta Innovates Health Senior Scholar Award and by the Alberta Cancer Foundation Weekend to End Women’s Cancers Breast Cancer Chair. Role of the funder: The funder did not play a role in the design, analysis, or interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada

    Kerry S. Courneya, Ki-Yong An, Fernanda Z. Arthuso, Gordon J. Bell, Spencer J. Allen, Stephanie M. Ntoukas & Myriam Filion

  2. Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada

    Andria R. Morielli, Qinggang Wang, Karen Kopciuk, Lin Yang, Leanne Dickau & Christine M. Friedenreich

  3. Department of Kinesiology, School of Health and Human Sciences, University of North Carolina, Greensboro, NC, USA

    Jessica McNeil

  4. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada

    Margaret L. McNeely

  5. Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada

    Jeff K. Vallance

  6. Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    S. Nicole Culos-Reed, Lin Yang & Christine M. Friedenreich

  7. Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada

    S. Nicole Culos-Reed

  8. Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Rockville, MD, USA

    Charles E. Matthews

  9. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

    John R. Mackey

Authors
  1. Kerry S. Courneya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ki-Yong An
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fernanda Z. Arthuso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gordon J. Bell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andria R. Morielli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jessica McNeil
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Qinggang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Spencer J. Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Stephanie M. Ntoukas
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Margaret L. McNeely
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jeff K. Vallance
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. S. Nicole Culos-Reed
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Karen Kopciuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Lin Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Charles E. Matthews
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Myriam Filion
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Leanne Dickau
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. John R. Mackey
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Christine M. Friedenreich
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: KSC, KYA, FZA, GJB, ARM, JM, QW, SJA, SMN, MLM, JKV, SNCR, KK, LY, CEM, MF, LD, JRM, CMF. Data curation: QW, KK. Formal analysis: KYA, FZA, QW, KK. Funding acquisition: KSC, GJB, MLM, JKV, SNCR, CEM, JRM, CMF. Investigation: KYA, FZA, GJB, ARM, SJA, SMN, MLM, MF, LD. Methodology: KSC, GJB, MLM, JKV, SNCR, CEM, CMF. Project administration: KSC, LD, MLM, CMF. Resources: KSC, JRM, CMF. Supervision: KSC, CMF. Writing—original draft: KSC, FZA, SJA, SMN. Writing—review and editing: KSC, KYA, FZA, GJB, ARM, JM, QW, SJA, SMN, MLM, JKV, SNCR, KK, LY, CEM, MF, LD, JRM, CMF.

Corresponding author

Correspondence to Kerry S. Courneya.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Courneya, K.S., An, KY., Arthuso, F.Z. et al. Associations between health-related fitness and quality of life in newly diagnosed breast cancer patients. Breast Cancer Res Treat 199, 533–544 (2023). https://doi.org/10.1007/s10549-023-06935-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-023-06935-x

Keywords

Search

Navigation