Breast Cancer Research and Treatment

, Volume 131, Issue 2, pp 679–690 | Cite as

Change in physical activity during active treatment in a prospective study of breast cancer survivors

  • Marilyn L. Kwan
  • Barbara Sternfeld
  • Isaac Joshua Ergas
  • Allegra W. Timperi
  • Janise M. Roh
  • Chi-Chen Hong
  • Charles P. Quesenberry
  • Lawrence H. Kushi


Physical activity offers many benefits to breast cancer survivors, yet research on physical activity during the immediate period following a breast cancer diagnosis is limited. In a prospective cohort study of 1,696 women diagnosed with invasive breast cancer in the Kaiser Permanente Northern California Medical Care Program from 2006–2009, we describe change in self-reported physical activity levels from around diagnosis to 6 months post-diagnosis and determine factors associated with change. Participants completed a comprehensive physical activity questionnaire at baseline (2 months post-diagnosis) and at follow-up (8 months post-diagnosis). Predictors of physical activity change were determined by multivariable linear regression. Reductions in all physical activity levels were observed (P < 0.0001); mean (SD) change (h/week) of moderate-vigorous physical activity (MVPA) was −1.28 (4.48) and sedentary behavior was −0.83 (6.95). In fully-adjusted models, overweight and obesity were associated with greater declines in MVPA of −1.58 h/week (SD = 0.92) and −1.29 h/week (SD = 0.93), respectively (P = 0.0079). Receipt of chemotherapy only was also associated with a greater decrease in MVPA (−2.12 h/week; SD = 0.92; P < 0.0001), specifically for recreational activities (−1.62 h/week; SD = 0.64; P = 0.0001). These data suggest challenges in maintaining physical activity levels during active treatment among women with breast cancer. Interventions to encourage physical activity in breast cancer survivors should be pursued.


Breast cancer Chemotherapy Cohort studies Physical activity Exercise Radiation therapy Sedentary lifestyle Cancer survivorship 



Body mass index


Estrogen receptor


Human epidermal growth factor receptor 2




Kaiser Permanente Northern California


Metabolic equivalent


Moderate-vigorous physical activity


Standard deviation


Progesterone receptor



This work was supported by the National Cancer Institute at the National Institutes of Health (grant number 2R01 CA105274). The authors thank office and field staff for data collection, processing, and preparation. We thank all Pathways Study participants for their numerous contributions to this study. The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the funding agencies.




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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Marilyn L. Kwan
    • 1
  • Barbara Sternfeld
    • 1
  • Isaac Joshua Ergas
    • 1
  • Allegra W. Timperi
    • 1
  • Janise M. Roh
    • 1
  • Chi-Chen Hong
    • 2
  • Charles P. Quesenberry
    • 1
  • Lawrence H. Kushi
    • 1
  1. 1.Division of ResearchKaiser PermanenteOaklandUSA
  2. 2.Division of Cancer Prevention & Population SciencesRoswell Park Cancer InstituteBuffaloUSA

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