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Exercise Before and After Breast Cancer Diagnosis Improves Survival, Reduces Recurrence Risk

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Doing the minimum amount of recommended exercise per week — 2.5 hours — both before and after being diagnosed with breast cancer with a high risk of recurrence is linked to better survival and a lower risk of recurrence, according to a study.

The research was published online on April 2, 2020, in the Journal of the National Cancer Institute. Read the abstract of “Physical activity, before, during and after chemotherapy for high-risk breast cancer: relationships with survival.”

Federal exercise guidelines

Regular exercise is an important part of being as healthy as you can be. More and more research shows that exercise can reduce the risk of breast cancer coming back (recurrence) if you've been diagnosed, as well as the risk of developing breast cancer if you’ve never been diagnosed.

The U.S. Department of Health and Human Services (HHS) recommends that adults should do:

  • at least 2.5 hours to 5 hours of exercise at moderate intensity per week; brisk walking is considered moderate intensity
  • or 75 minutes to 2.5 hours of exercise at vigorous intensity per week; running or other high-intensity cardio is considered vigorous intensity

The HHS also recommends that adults should do muscle-strengthening exercises 2 or more days per week.

A number of organizations, including the American Cancer Society and the American College of Sports Medicine, have published exercise recommendations specifically for people living with and beyond cancer. Still, most people who have been diagnosed with cancer don’t exercise regularly.

About the study

For this study, the researchers wanted to know how exercise affected outcomes for women diagnosed with breast cancer considered high risk, meaning the cancer had a high risk of recurrence.

The study included 1,340 women who were diagnosed with stage I, stage II, or stage III breast cancer with a high risk of recurrence. All the women had surgery to remove the cancer followed by chemotherapy.

The women filled out questionnaires on their exercise habits before being diagnosed as well as their current exercise routines. The questionnaires asked about:

  • what type of exercise the women did
  • how long they exercised
  • how often they exercised

The women filled out the questionnaires four times:

  • when they enrolled in the study
  • while they were undergoing chemotherapy treatment
  • 1 year after completing breast cancer treatment
  • 2 years after completing breast cancer treatment

The researchers found that women who met the minimum federal exercise guidelines of 2.5 hours of moderate-intensity exercise per week, before and after being diagnosed with breast cancer, had:

  • a 55% lower risk of recurrence compared to women who didn’t meet the minimum guidelines
  • a 68% lower risk of dying compared to women who didn’t meet the minimum guidelines

Even women who started exercising only after breast cancer treatment was completed got benefits from the physical activity: they had a 46% lower risk of recurrence and a 43% lower risk of dying compared to women who didn’t meet the minimum guidelines.

The results also found that a few hours of consistent, weekly exercise led to the same survival benefits as exercising for longer periods of time each week.

"What these results suggest for doctors — and patients — is that even a modest exercise routine, taken up after cancer treatment, can help women with high-risk breast cancer live longer and healthier lives," said lead author Rikki Cannioto, assistant professor of oncology at the Roswell Park Comprehensive Cancer Center. "It's never too late to start walking, doing yoga, cycling, or swimming — and that activity certainly appears to pay off."

What this means for you

This study offers more evidence of how important exercise is for everyone, but especially for women who have been diagnosed with breast cancer.

Even if you didn’t exercise before being diagnosed, this study shows that doing just 2.5 hours of brisk walking per week — about 20 minutes each day — after you completed treatment can help lower the risk of the cancer coming back and also can help you live longer.

Still, we know that if you’re recovering from breast cancer treatment or are still in treatment, along with being busy with work, household chores, and family matters, finding time to exercise almost every day can seem impossible.

It can help to break up your exercise into 20- or 30-minute sessions that add up to at least 2.5 hours per week. Walking is a great way to start. Maybe you walk 15 minutes before going to work and 20 minutes on your lunch break. You can add a few more minutes by parking farther away from your building or taking mass transit. Or you can make plans to walk with a friend after work — you’re more likely to stick with an exercise plan if someone else is counting on you. Plus, you can socialize at the same time.

No matter how old you are, it’s never too late or too soon to get moving. And once you do start, keep at it!

Visit the Exercise section for tips on exercising safely and how to stick to an exercise routine.

To talk with others about the benefits of exercise, share exercise tips, and get encouragement, join the Discussion Board forum Fitness and Getting Back in Shape.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser

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