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Physical activity among patients with breast cancer receiving aromatase inhibitors is associated with bone health: a cross-sectional observational study

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

Abstract

Purpose

To examine the association of physical activity (PA) with bone health among patients with breast cancer receiving adjuvant aromatase inhibitor (AI) treatment.

Methods

In this single-center observational study, we enrolled postmenopausal women with primary hormone receptor-positive breast cancer who were receiving adjuvant AI treatment. We assessed patient bone health [bone mineral density (BMD) and biomarkers of bone turnover] as main outcomes. PA was assessed using Baecke physical activity questionnaires (BPAQ) and an accelerometer. Multiple regression analysis was performed after adjustment for age, body mass index, smoking history and duration of AI treatment. For missing data, multiple imputation analysis was adapted.

Results

The mean age of the 53 enrolled patients was 67.4 ± 8.4 years. The mean duration of AI administration was 25.7 ± 18.9 months. The most frequently administered AI was anastrozole (73.6%). Although not related to BMD, PA was related to bone turnover. Serum collagen type I amino-terminal propeptide, a bone formation marker, was associated with only light PA (t =  − 2.55, p = 0.015), while tartrate-resistant acid phosphatase 5b, a bone absorption marker, was associated with work index in the BPAQ subscale and light PA (t =  − 2.28, p = 0.028, t =  − 2.26, p = 0.031, respectively). The results for all patients were similar to those observed in the multiple imputation analysis.

Conclusion

PA was significantly associated with bone turnover among cancer patients receiving AI treatment. Light PA and PA in the work domain were the most important factors among various PA intensities and PA domains.

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Data availability

The study protocol that approved by the Ethics Committee of the Kobe University Graduate School of Health Sciences was not allowed to share any outside with the dataset.

Abbreviations

LC:

Lifecorder

PINP:

Collagen type I amino-terminal propeptide

TRACP-5b:

Tartrate-resistant acid phosphatase 5b

PA:

Physical activity

DXA:

Dual energy X-ray absorptiometry

AI:

Aromatase inhibitor

BPAQ:

Baecke physical activity questionnaires

VPA:

Vigorous physical activity

MPA:

Moderate physical activity

LPA:

Light physical activity

SB:

Sedentary behaviour

MET:

Metabolic equivalents

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Acknowledgements

The authors are extremely grateful to the patients who participated in this study and all the staff members of the Department of Breast Surgery at Kobe University Hospital.

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Authors and Affiliations

  1. Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan

    Takashi Saito & Rei Ono

  2. Kobe University Hospital, Kobe, Japan

    Takashi Saito, Shintaro Takao & Yoshitada Sakai

  3. Steel Memorial Hirohata Hospital, Himeji, Japan

    Seishi Kono

  4. Chukyo Hospital of Japan Community Health Care Organization, Nagoya, Japan

    Mika Asano

  5. Nagoya University Hospital, Nagoya, Japan

    Akimasa Fukuta

  6. First Towakai Hospital, Takatsuki, Japan

    Yuko Tanaka

  7. Hyogo Cancer Center, Akashi, Japan

    Shintaro Takao

  8. Department of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshitada Sakai

Authors
  1. Takashi Saito
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  2. Rei Ono
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  3. Seishi Kono
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  4. Mika Asano
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  5. Akimasa Fukuta
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  6. Yuko Tanaka
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  8. Yoshitada Sakai
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Contributions

TS: Conceptualization, Methodology, Formal Analysis, Visualization, Writing (Original Draft), and Investigation. RO: Conceptualization, Writing (Review and Editing), Visualization, and Project Administration. SK: Conceptualization and Resources. MA: Conceptualization, Methodology, Formal Analysis, and Investigation. AF: Investigation. YT: Methodology and Resources. ST: Resources. YS: Methodology and Supervision.

Corresponding author

Correspondence to Rei Ono.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The present study was performed in accordance with the tenets of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethics Committee of the Kobe University Graduate School of Health Sciences.

Research involving human and animal participants

This article does not contain any studies with animals performed by any of the authors.

Informed consent

All patients were informed of the study protocol and signed an informed consent form before assessment.

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Saito, T., Ono, R., Kono, S. et al. Physical activity among patients with breast cancer receiving aromatase inhibitors is associated with bone health: a cross-sectional observational study. Breast Cancer Res Treat 182, 187–193 (2020). https://doi.org/10.1007/s10549-020-05668-5

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  • DOI: https://doi.org/10.1007/s10549-020-05668-5

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