Advantages of exercise in breast cancer patients and survivors in addition to its mitigating effect on chest wall pain

Letter to the Editor

Advantages of exercise in breast cancer patients and survivors in addition to its mitigating effect on chest wall pain

Shailendra Kapoor , MD
Private practice, Mechanicsville, Virginia, U.S.A..

The Editor

Current Oncology

October 29, 2012

The recent article by Wong et al. was highly interesting1. Exercise—especially aerobic exercise—has several beneficial effects in breast cancer patients and survivors besides mitigating chest wall pain.

Exercise regimens result in a reduction of progesterone and estrogen levels in premenopausal women at high risk of developing breast malignancies, thus attenuating the risk of breast cancers developing. In fact, Kossman et al. 2 reported that, after exercise, total progesterone exposure is decreased by nearly 24%. Exercise not only reduces breast tumour size, but also number3. In addition, cardiotoxic side effects secondary to chemotherapy with anthracyclines in breast cancer patients can be significantly decreased and attenuated by the initiation of aerobic exercise regimens in these patients4. Similarly, Chen et al. showed that exercise in the initial 3 years after a diagnosis of breast cancer is inversely related to disease-specific mortality, with a hazard ratio of 0.65.

The maximum aerobic capacity is significantly increased in breast cancer survivors after moderate-intensity aerobic exercise, even for durations as short as 3 weeks6. Similarly, the restore study showed that tailor-made exercise regimens initiated within the initial 3 months after breast surgery significantly enhance physical functioning without affecting quality of life7. Similarly, femoral neck bone mass loss in breast cancer patients in the premenopausal age groups is almost completely mitigated with the use of aerobic exercise regimens inclusive of circuit training and jumping8.

In addition, exercises targeting the upper extremities markedly improved the range of motion of the shoulder joint in breast cancer survivors9. Similarly, the early initiation of exercise in the postoperative period is associated with attenuated risk for the development of lymphedema10.

The above examples clearly highlight the advantages of exercise in breast cancer patients and survivors and the need for further studies to fully elaborate the beneficial effects of exercise.


The author has no financial conflicts of interest to disclose.


1. Wong P, Muanza T, Hijal T, et al. Effect of exercise in reducing breast and chest-wall pain in patients with breast cancer: a pilot study. Curr Oncol 2012;19:e129–35.
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2. Kossman DA, Williams NI, Domchek SM, Kurzer MS, Stopfer JE, Schmitz KH. Exercise lowers estrogen and progesterone levels in premenopausal women at high risk of breast cancer. J Appl Physiol 2011;111:1687–93.
cross-ref  pubmed  

3. Murphy EA, Davis JM, Barrilleaux TL, et al. Benefits of exercise training on breast cancer progression and inflammation in C3(1)SV40Tag mice. Cytokine 2011;55:274–9.
cross-ref  pubmed  

4. Scott JM, Khakoo A, Mackey JR, Haykowsky MJ, Douglas PS, Jones LW. Modulation of anthracycline-induced cardiotoxicity by aerobic exercise in breast cancer: current evidence and underlying mechanisms. Circulation 2011;124:642–50.
cross-ref  pubmed  pmc  

5. Chen X, Lu W, Zheng W, et al. Exercise after diagnosis of breast cancer in association with survival. Cancer Prev Res (Phila) 2011;4:1409–18.

6. Brdareski Z, Djurović A, Susnjar S, et al. Effects of a short-term differently dosed aerobic exercise on maximum aerobic capacity in breast cancer survivors: a pilot study. Vojnosanit Pregl 2012;69:237–42.
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7. Anderson RT, Kimmick GG, McCoy TP, et al. A randomized trial of exercise on well-being and function following breast cancer surgery: the restore trial. J Cancer Surviv 2012;6:172–81.

8. Saarto T, Sievänen H, Kellokumpu–Lehtinen P, et al. Effect of supervised and home exercise training on bone mineral density among breast cancer patients. A 12-month randomised controlled trial. Osteoporos Int 2012;23:1601–12.

9. Petito EL, Nazário AC, Martinelli SE, Facina G, De Gutiérrez MG. Application of a domicile-based exercise program for shoulder rehabilitation after breast cancer surgery [English, Portuguese, Spanish]. Rev Lat Am Enfermagem 2012;20:35–43.
cross-ref  pubmed  

10. Cavanaugh KM. Effects of early exercise on the development of lymphedema in patients with breast cancer treated with axillary lymph node dissection. J Oncol Pract 2011;7:89–93.
cross-ref  pubmed  pmc

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Current Oncology , VOLUME 20 , NUMBER 1 , FEBRUARY 2013

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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)