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. 2025 Jan 4;59(1):kaaf098.
doi: 10.1093/abm/kaaf098.

Changes in physical activity 1 year after breast cancer diagnosis and associations with patient-reported outcomes: results from the AMBER cohort

Jeff Vallance  1 , Christine Friedenreich  2   3 , Ruixuan Zhang  2 , Qinggang Wang  2 , Charles Matthews  4 , Lin Yang  2   3 , Margaret McNeely  5 , Chad Wagoner  6 , Nicole Culos-Reed  7 , Gordon Bell  8 , Jessica McNeil  9 , Leanne Dickau  2 , Kerry Courneya  8
Affiliations

Changes in physical activity 1 year after breast cancer diagnosis and associations with patient-reported outcomes: results from the AMBER cohort

Jeff Vallance et al. Ann Behav Med. .

Abstract

Background: Few studies have prospectively examined how changes in physical activity in the first year after a breast cancer diagnosis may affect patient-reported outcomes (PROs) including quality of life and fatigue.

Purpose: The purpose of this study was to examine changes in device-measured physical activity and associations with changes in quality of life [physical composite summary score (PCS) and mental composite summary score (MCS)] and fatigue from the first year after diagnosis among newly diagnosed women with breast cancer in the Alberta Moving Beyond Breast Cancer Study.

Methods: In this prospective cohort study, we assessed women within a median of 60 days postsurgery (N = 1442) and again 1 year later (N = 1194). At both timepoints, participants wore an ActiGraph accelerometer for 7 days to measure light and moderate-to-vigorous physical activity (MVPA) and an activPAL accelerometer for daily steps. We used analysis of covariance to compare PRO change scores (dependent variables: PCS and MCS, and fatigue) across activity change quartiles (Q).

Results: Participants were categorized into Q1 (decreased activity: mean changes = -37.2 minutes/day), Q2 (stable activity: mean change = -4.8 minutes/day), Q3 (modest increase in activity: mean change = 13.2 minutes/day), and Q4 (large increase in activity: mean change = +49.8 minutes/day). For MVPA, participants in Q4 had significantly larger improvements in PCS and MCS compared with those in the lowest quartiles (PCS: Q1 Δ = 1.5 points, P = .026; Q2 Δ = 1.6 points, P = .017; MCS: Q1 Δ = 2.2 points, P = .007). Significant differences also emerged for fatigue as participants in Q4 of MVPA reported improvements in fatigue compared to those in Q1 (Δ = 1.9 points, P = .017) and Q2 (Δ = 1.9 points, P = .016). Improvements in PCS, MCS, and fatigue were observed when comparing the highest quartile of change (Q4) in light intensity activity, daily steps, and MVPA in ≥10-minute bouts to those in Q1 and Q2.

Conclusions: Women with breast cancer who increased physical activity from diagnosis to 1 year had significantly better improvements in PCS, MCS, and fatigue compared with those who decreased or maintained their physical activity.

Keywords: accelerometers; breast cancer; fatigue; physical activity; prospective cohort; quality of life; survivorship; walking.

Plain language summary

We recently completed the Alberta Moving Beyond Breast Cancer (AMBER) study; the first and only prospective cohort study designed to examine the role of device-based and self-reported physical activity, sedentary behavior, and health-related fitness in breast cancer survivorship from the time of diagnosis and into survivorship. In this paper, we examined associations between device-measured physical activity (ie, average daily steps, daily light intensity hours, and moderate-to-vigorous physical activity intensity hours) with changes in quality of life and fatigue in the first year after diagnosis. Few studies have monitored physical activity behaviors in the first year after a breast cancer diagnosis. In the first year after diagnosis, we found that participants with the largest increases in moderate-to-vigorous physical activity had significantly greater improvements in quality of life and fatigue compared with those participants that decreased in their physical activity behaviors. These findings add to the literature highlighting the importance of being physically active after a breast cancer diagnosis.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Differences in quality of life and fatigue from baseline to 1 year follow-up across physical activity quartiles in Alberta Moving Beyond Breast Cancer cohort study participants, 2012-2021.
See this image and copyright information in PMC

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