Breast Cancer Research and Treatment

, Volume 168, Issue 1, pp 147–157 | Cite as

Adipose tissue inflammation in breast cancer survivors: effects of a 16-week combined aerobic and resistance exercise training intervention

  • Christina M. Dieli-ConwrightEmail author
  • Jean-Hugues Parmentier
  • Nathalie Sami
  • Kyuwan Lee
  • Darcy Spicer
  • Wendy J. Mack
  • Fred Sattler
  • Steven D. Mittelman
Clinical trial



Obesity is a leading modifiable contributor to breast cancer mortality due to its association with increased recurrence and decreased overall survival rate. Obesity stimulates cancer progression through chronic, low-grade inflammation in white adipose tissue, leading to accumulation of adipose tissue macrophages (ATMs), in particular, the pro-inflammatory M1 phenotype macrophage. Exercise has been shown to reduce M1 ATMs and increase the more anti-inflammatory M2 ATMs in obese adults. The purpose of this study was to determine whether a 16-week exercise intervention would positively alter ATM phenotype in obese postmenopausal breast cancer survivors.


Twenty obese postmenopausal breast cancer survivors were randomized to a 16-week aerobic and resistance exercise (EX) intervention or delayed intervention control (CON). The EX group participated in 16 weeks of supervised exercise sessions 3 times/week. Participants provided fasting blood, dual-energy X-ray absorptiometry (DXA), and superficial subcutaneous abdominal adipose tissue biopsies at baseline and following the 16-week study period.


EX participants experienced significant improvements in body composition, cardiometabolic biomarkers, and systemic inflammation (all p < 0.03 vs. CON). Adipose tissue from EX participants showed a significant decrease in ATM M1 (p < 0.001), an increase in ATM M2 (p < 0.001), increased adipose tissue secretion of anti-inflammatory cytokines such as adiponectin, and decreased secretion of the pro-inflammatory cytokines IL-6 and TNF- α (all p < 0.055).


A 16-week aerobic and resistance exercise intervention attenuates adipose tissue inflammation in obese postmenopausal breast cancer survivors. Future large randomized trials are warranted to investigate the impact of exercise-induced reductions in adipose tissue inflammation and breast cancer recurrence.


Adipose tissue Macrophages Obesity Body composition 



We are grateful to the Clinical Investigations Support Office of the Norris Comprehensive Cancer Center for their support of this investigation and the extreme generosity of our study participants. This work was supported by grants K07CA160718 from the National Cancer Institute; and grants UL1TR001855 and UL1TR000130 from the National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health. The content is solely the responsibility of the authors, and does not necessarily represent the official views of the National Institutes of Health.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts 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.


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© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Division of Biokinesiology and Physical Therapy, Ostrow School of DentistryUniversity of Southern California (USC)Los AngelesUSA
  2. 2.Diabetes & Obesity Program and Department of Pediatrics, Children’s Hospital Los AngelesKeck School of Medicine (KSOM)Los AngelesUSA
  3. 3.Department of Medicine, KSOMUSCLos AngelesUSA
  4. 4.Department of Preventive Medicine, KSOMUSCLos AngelesUSA
  5. 5.Division of Pediatric Endocrinology, Mattel Children’s HospitalUniversity of California, Los AngelesLos AngelesUSA

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