Supportive Care in Cancer

, Volume 24, Issue 5, pp 2181–2190 | Cite as

How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors?

  • Terry Boyle
  • Jeff K. Vallance
  • Emily K. Ransom
  • Brigid M. Lynch
Original Article



Physical activity (PA) and sedentary behavior may influence the physical and mental health of breast cancer survivors; however, few studies have objectively measured these behaviors in this population. We used accelerometers to measure the PA and sedentary time levels of breast cancer survivors and examined the demographic, behavioral, and medical correlates of these behaviors using two complementary approaches.


A total of 259 breast cancer survivors wore an accelerometer for 7 days during waking hours and completed a questionnaire. We used linear regression and classification trees to investigate correlates of PA and sedentary time.


The breast cancer survivors in this study (mean age = 61 years, mean time since diagnosis = 3 years) were sedentary for a daily average of 8.2 h, in light-intensity PA for 5.8 h and in moderate-to-vigorous intensity PA (MVPA) for 32 min, with 16 % meeting PA guidelines. Participants with high comorbidity were the least likely to be meeting guidelines (0 %), while a subgroup of participants with no/low comorbidity, a university degree, and higher levels of pre-diagnosis MVPA were the most likely to be meeting guidelines (47 %). Older participants (70+ years) were the most likely to have sedentary time levels at least twice as high as activity levels, while participants who were younger than 70 years and not in the lowest category of pre-diagnosis MVPA were the least likely.


Interventions to facilitate physical activity and reduce sedentary time among breast cancer survivors should consider comorbidity status and previous PA experience.


Cancer Oncology Survivorship Breast cancer Physical activity Sedentary behavior 



The ACCEL-Breast study was funded by a project grant from the Breast Cancer Research Centre—Western Australia. The case-control study (the Breast Cancer Environment and Employment Study) was funded by the Australian National Health and Medical Research Council (#573530). Terry Boyle is supported by an Early Career Fellowship from the Australian National Health and Medical Research Council (#1072266), a Fellowship from the Canadian Institutes of Health Research (#300068), a Postdoctoral Fellowship from the Michael Smith Foundation for Health Research (#5553), and an Honorary Killam Postdoctoral Research Fellowship from Killam Trusts/The University of British Columbia. Jeff Vallance is supported by the Canada Research Chairs program and a Population Health Investigator Award from Alberta Innovates—Health Solutions. Brigid Lynch is supported by an Early Career Fellowship from the National Breast Cancer Foundation. We would like to acknowledge the Chief Investigators of the case-control study (in particular Professor Lin Fritschi from the School of Public Health at Curtin University and Professor Jane Heyworth from the School of Population Health at The University of Western Australia), and Ms Jessica Occleston at the Baker IDI Heart and Diabetes Institute for her assistance in data processing. We also sincerely thank the people who took the time to participate in this study.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

520_2015_3011_MOESM1_ESM.docx (26 kb)
Supplementary Table 1 (DOCX 26 kb)


  1. 1.
    Schmitz K (2011) Physical activity and breast cancer survivorship. In: Courneya KS, Friedenreich CM (eds) Physical activity and cancer. Springer, Berlin Heidelberg, pp 189–215Google Scholar
  2. 2.
    Schmid D, Leitzmann MF (2014) Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol 25:1293–1311CrossRefPubMedGoogle Scholar
  3. 3.
    Lynch BM, Dunstan DW, Vallance JK, Owen N (2013) Don’t take cancer sitting down. Cancer 119:1928–1935CrossRefPubMedGoogle Scholar
  4. 4.
    Mason C, Alfano CM, Smith AW, Wang CY, Neuhouser ML, Duggan C, Bernstein L, Baumgartner KB, Baumgartner RN, Ballard-Barbash R, McTiernan A (2013) Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomarkers Prev 22:1153–1161CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Brunet J, Amireault S, Chaiton M, Sabiston CM (2014) Identification and prediction of physical activity trajectories in women treated for breast cancer. Ann Epidemiol 24:837–842CrossRefPubMedGoogle Scholar
  6. 6.
    Hair BY, Hayes S, Tse C-K, Bell MB, Olshan AF (2014) Racial differences in physical activity among breast cancer survivors: implications for breast cancer care. Cancer 120:2174–2182CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Keegan TM, Shariff-Marco S, Sangaramoorthy M, Koo J, Hertz A, Schupp C, Yang J, John E, Gomez S (2014) Neighborhood influences on recreational physical activity and survival after breast cancer. Cancer Causes Control 25:1295–1308CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26:2198–2204CrossRefPubMedGoogle Scholar
  9. 9.
    Sabiston CM, Brunet J, Vallance JK, Meterissian S (2014) Prospective examination of objectively assessed physical activity and sedentary time after breast cancer treatment: sitting on the crest of the teachable moment. Cancer Epidemiol Biomarkers Prev 23:1324–1330CrossRefPubMedGoogle Scholar
  10. 10.
    Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E (2015) Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer. doi: 10.1002/cncr.29620, Advance online publicationGoogle Scholar
  11. 11.
    Boyle T, Lynch BM, Courneya KS, Vallance JK (2015) Agreement between accelerometer-assessed and self-reported physical activity and sedentary time in colon cancer survivors. Support Care Cancer 23:1121–1126CrossRefPubMedGoogle Scholar
  12. 12.
    Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N (2010) Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control 21:283–288CrossRefPubMedGoogle Scholar
  13. 13.
    George SM, Alfano CM, Wilder Smith A, Irwin ML, McTiernan A, Bernstein L, Baumgartner KB, Ballard-Barbash R (2013) Sedentary behavior, health-related quality of life, and fatigue among breast cancer survivors. J Phys Act Health 10:350–358CrossRefPubMedGoogle Scholar
  14. 14.
    Bock C, Schmidt ME, Vrieling A, Chang-Claude J, Steindorf K (2013) Walking, bicycling, and sports in postmenopausal breast cancer survivors—results from a German patient cohort study. Psychooncology 22:1291–1298CrossRefPubMedGoogle Scholar
  15. 15.
    Lemon S, Roy J, Clark M, Friedmann P, Rakowski W (2003) Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med 26:172–181CrossRefPubMedGoogle Scholar
  16. 16.
    Frank LD, Kerr J, Sallis JF, Miles R, Chapman J (2008) A hierarchy of sociodemographic and environmental correlates of walking and obesity. Prev Med 47:172–178CrossRefPubMedGoogle Scholar
  17. 17.
    Boslaugh SE, Kreuter MW, Nicholson RA, Naleid K (2005) Comparing demographic, health status and psychosocial strategies of audience segmentation to promote physical activity. Health Educ Res 20:430–438CrossRefPubMedGoogle Scholar
  18. 18.
    Dominick G, Papas M, Rogers M, Rakowski W (2015) Classification tree analysis to examine influences on colorectal cancer screening. Cancer Causes Control 26:443–454CrossRefPubMedGoogle Scholar
  19. 19.
    Ransom EK, Lynch BM, Vallance JK, Boyle T (2015) Offering personalized health behavior feedback did not increase response rate: a randomized controlled trial. J Clin Epidemiol 68:1383–1384CrossRefPubMedGoogle Scholar
  20. 20.
    Fritschi L, Erren TC, Glass DC, Girschik J, Thomson AK, Saunders C, Boyle T, El-Zaemey S, Rogers P, Peters S, Slevin T, D’Orsogna A, de Vocht F, Vermeulen R, Heyworth JS (2013) The association between different night shiftwork factors and breast cancer: a case–control study. Br J Cancer 109:2472–2480CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Freedson PS, Melanson E, Sirard J (1998) Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc 30:777–781CrossRefPubMedGoogle Scholar
  22. 22.
    Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP (2008) Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 167:875–881CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Dunstan DW, Kingwell BA, Larsen R, Healy GN, Cerin E, Hamilton MT, Shaw JE, Bertovic DA, Zimmet PZ, Salmon J, Owen N (2012) Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care 35:976–983CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Canadian Society for Exercise Physiology (2011) Canadian physical activity guidelines: 2011 scientific statements. Canadian Society for Exercise Physiology, OttawaGoogle Scholar
  25. 25.
    Physical Activity Guidelines Advisory Committee (2008) Physical activity guidelines advisory committee report, 2008. U.S. Department of Health and Human Services, Washington, DCGoogle Scholar
  26. 26.
    Australian Bureau of Statistics (2013) Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2011. Catalogue Number 2033.0.55.001. Australian Bureau of Statistics, Canberra, AustraliaGoogle Scholar
  27. 27.
    Boyle T, Heyworth J, Bull F, Fritschi L (2013) Test-retest reliability of transport-related physical activity performed over the lifetime. J Phys Act Health 10:626–631CrossRefPubMedGoogle Scholar
  28. 28.
    Chasan-Taber L, Erickson JB, McBride JW, Nasca PC, Chasan-Taber S, Freedson PS (2002) Reproducibility of a self-administered lifetime physical activity questionnaire among female college alumnae. Am J Epidemiol 155:282–291CrossRefPubMedGoogle Scholar
  29. 29.
    Horne JA, Östberg O (1977) Individual differences in human circadian rhythms. Biol Psychol 5:179–190CrossRefPubMedGoogle Scholar
  30. 30.
    Kass GV (1980) An exploratory technique for investigating large quantities of categorical data. J R Stat Soc: Ser C: Appl Stat 29:119–127Google Scholar
  31. 31.
    Ramin C, Devore EE, Pierre-Paul J, Duffy JF, Hankinson SE, Schernhammer ES (2013) Chronotype and breast cancer risk in a cohort of U.S. nurses. Chronobiol Int 30:1181–1186CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Haraszti RÁ, Purebl G, Salavecz G, Poole L, Dockray S, Steptoe A (2014) Morningness–eveningness interferes with perceived health, physical activity, diet and stress levels in working women: a cross-sectional study. Chronobiol Int 31:829–837CrossRefPubMedGoogle Scholar
  33. 33.
    Urban R, Magyarodi T, Rigo A (2011) Morningness-eveningness, chronotypes and health-impairing behaviors in adolescents. Chronobiol Int 28:238–247CrossRefPubMedGoogle Scholar
  34. 34.
    Schaal S, Peter M, Randler C (2010) Morningness‐eveningness and physical activity in adolescents. International Journal of Sport and Exercise Psychology 8:147–159CrossRefGoogle Scholar
  35. 35.
    Roeser K, Obergfell F, Meule A, Vögele C, Schlarb AA, Kübler A (2012) Of larks and hearts—morningness/eveningness, heart rate variability and cardiovascular stress response at different times of day. Physiol Behav 106:151–157CrossRefPubMedGoogle Scholar
  36. 36.
    Gaina A, Sekine M, Kanayama H, Takashi Y, Hu L, Sengoku K, Kagamimori S (2006) Morning‐evening preference: sleep pattern spectrum and lifestyle habits among Japanese junior high school pupils. Chronobiol Int 23:607–621CrossRefPubMedGoogle Scholar
  37. 37.
    Kauderer S, Randler C (2012) Differences in time use among chronotypes in adolescents. Biol Rhythm Res 44:601–608CrossRefGoogle Scholar
  38. 38.
    Brown WJ, Mishra G, Lee C, Bauman A (2000) Leisure time physical activity in Australian women: relationship with well being and symptoms. Res Q Exerc Sport 71:206–216CrossRefPubMedGoogle Scholar
  39. 39.
    Scharff DP, Homan S, Kreuter M, Brennan L (1999) Factors associated with physical activity in women across the life span: implications for program development. Women Health 29:115–134CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Terry Boyle
    • 1
    • 2
    • 3
  • Jeff K. Vallance
    • 4
  • Emily K. Ransom
    • 3
  • Brigid M. Lynch
    • 5
    • 6
    • 7
  1. 1.Cancer Control ResearchBritish Columbia Cancer AgencyVancouverCanada
  2. 2.School of Population and Public HealthThe University of British ColumbiaVancouverCanada
  3. 3.Centre for Medical ResearchThe University of Western AustraliaPerthAustralia
  4. 4.Faculty of Health DisciplinesAthabasca UniversityAthabascaCanada
  5. 5.Cancer Epidemiology CentreCancer Council VictoriaMelbourneAustralia
  6. 6.School of Population and Global HealthThe University of MelbourneMelbourneAustralia
  7. 7.Physical Activity LaboratoryBaker IDI Heart and Diabetes InstituteMelbourneAustralia

Personalised recommendations