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Meta-Analysis
. 2022 Nov 1;6(6):pkac072.
doi: 10.1093/jncics/pkac072.

Physical Activity and Health-Related Quality of Life in Women With Breast Cancer: A Meta-Analysis

Dagfinn Aune  1   2   3   4 , Georgios Markozannes  1   5 , Leila Abar  1 , Katia Balducci  1 , Margarita Cariolou  1 , Neesha Nanu  1 , Rita Vieira  1 , Yusuf O Anifowoshe  1 , Darren C Greenwood  6 , Steven K Clinton  7   8 , Edward L Giovannucci  9   10   11 , Marc J Gunter  12 , Alan Jackson  13 , Ellen Kampman  14 , Vivien Lund  15 , Anne McTiernan  16   17   18 , Elio Riboli  1 , Kate Allen  15 , Nigel T Brockton  19 , Helen Croker  15 , Daphne Katsikioti  15 , Deirdre McGinley-Gieser  15 , Panagiota Mitrou  15 , Martin Wiseman  15 , Galina Velikova  20 , Wendy Demark-Wahnefried  21 , Teresa Norat  1 , Konstantinos K Tsilidis  1   5 , Doris S M Chan  1
Affiliations
Meta-Analysis

Physical Activity and Health-Related Quality of Life in Women With Breast Cancer: A Meta-Analysis

Dagfinn Aune et al. JNCI Cancer Spectr. .

Abstract

Background: Physical activity (PA) is associated with improved health-related quality of life (HRQoL) among women with breast cancer; however, uncertainty remains regarding PA types and dose (frequency, duration, intensity) and various HRQoL measures. A systematic review and meta-analysis of randomized controlled trials was conducted to clarify whether specific types and doses of physical activity was related to global and specific domains of HRQoL, as part of the Global Cancer Update Programme, formerly known as the World Cancer Research Fund-American Institute for Cancer Research Continuous Update Project.

Methods: PubMed and CENTRAL databases were searched up to August 31, 2019. Weighted mean differences (WMDs) in HRQoL scores were estimated using random effects models. An independent expert panel graded the evidence.

Results: A total of 79 randomized controlled trials (14 554 breast cancer patients) were included. PA interventions resulted in higher global HRQoL as measured by the Functional Assessment of Cancer Therapy-Breast (WMD = 5.94, 95% confidence intervals [CI] = 2.64 to 9.24; I2 = 59%, n = 12), Functional Assessment of Cancer Therapy-General (WMD = 4.53, 95% CI = 1.94 to 7.13; I2 = 72%, n = 18), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (WMD = 6.78, 95% CI = 2.61 to 10.95; I2 = 76.3%, n = 17). The likelihood of causality was considered probable that PA improves HRQoL in breast cancer survivors. Effects were weaker for physical function and mental and emotional health. Evidence regarding dose and type of PA remains insufficient for firm conclusions.

Conclusion: PA results in improved global HRQoL in breast cancer survivors with weaker effects observed for physical function and mental and emotional health. Additional research is needed to define the impact of types and doses of activity on various domains of HRQoL.

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Figures

Figure 1.
Figure 1.
Flow chart of study selection. HRQoL = health-related quality of life; RCT = randomized controlled trial.
Figure 2.
Figure 2.
Summary of the risk of bias assessment across studies.
Figure 3.
Figure 3.
Summary of the risk of bias assessment for the individual studies. Aer = aerobic; Ca-rich diet = calcium-rich diet; CBT = cognitive behavioral therapy; CDT = complex decongestive therapy; Coun = counseling; Edu = education; EORTC QLQ-C30 = European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30; face = face-to-face intervention; FACT-An = Functional Assessment of Cancer Therapy–Anemia; FACT-B = Functional Assessment of Cancer Therapy–General and Breast cancer; FACT-B+4 = Functional Assessment of Cancer Therapy for Breast Cancer B + 4; FACT-Cog = Functional Assessment of Cancer Therapy–Cognitive; FACT-ES = Functional Assessment of Cancer Therapy–Endocrine Symptoms; FACT-F = Functional Assessment of Cancer Therapy–Fatigue; FACT-G = Functional Assessment of Cancer Therapy–General; FACIT-F = Functional Assessment of Chronic Illness Therapy–Fatigue; HIIT = high-intensity interval training; HRQoL = health-related quality of life; PA = physical activity; Rehab = rehabilitation; Relax = relaxation; Res = resistance; SF-12 = Short Form 12; SF-36 = Short Form-36; ST = supportive therapy; tel = over-the-telephone intervention; UC = usual care; WL = wait list.
Figure 4.
Figure 4.
Summary weighted mean differences and weighted mean change differences (95% confidence intervals) for physical activity and different domains of health-related quality of life. Effects that were considered clinically significant are marked with *. CI = confidence interval; EORTC QLQ-C30 = European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30; ES = effect size; FACT-B = Functional Assessment of Cancer Therapy–General and breast cancer; FACT-G = Functional Assessment of Cancer Therapy–General; FACIT-F = Functional Assessment of Chronic Illness Therapy–Fatigue; HRQoL = health-related quality of life; MOS/RAND SF-36 = Medical Outcomes Study and RAND Short Form-36; PA = physical activity; WMCD = weighted mean change difference; WMD = weighted mean difference.
Figure 5.
Figure 5.
Summary standardized mean differences (95% confidence intervals) for physical activity and different domains of health-related quality of life. Effects that were considered clinically significant are marked with *. CI = confidence interval; EORTC QLQ-C30 = European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30; ES = effect size; FACT-B = Functional Assessment of Cancer Therapy–General and breast cancer; FACT-G = Functional Assessment of Cancer Therapy–General; FACIT-F = Functional Assessment of Chronic Illness Therapy–Fatigue; HRQoL = health-related quality of life; MOS/RAND SF-36 = Medical Outcomes Study and RAND Short Form-36; PA = physical activity; SMD = standardized mean difference.
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References

    1. World Health Organization. WHO Definition of Health. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference. New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States and entered into force on 7 April 1948. https://www.who.int/about/governance/constitution#:~:text=Health%20is%20.... Accessed November 11, 2022.
    1. DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P.. Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med. 2006;21(3):267-275. - PMC - PubMed
    1. Epplein M, Zheng Y, Zheng W, et al.Quality of life after breast cancer diagnosis and survival. J Clin Oncol. 2011;29(4):406-412. - PMC - PubMed
    1. O’Mara AM, Denicoff AM.. Health related quality of life in NCI-sponsored cancer treatment trials. Semin Oncol Nurs. 2010;26(1):68-78. - PubMed
    1. Lipsett A, Barrett S, Haruna F, Mustian K, O’Donovan A.. The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: a systematic review and meta-analysis. Breast. 2017;32:144-155. - PubMed

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