Doing regular physical exercise has enormous benefits for your health, including reducing the chances of having a breast cancer diagnosis. Here we tell you how exercise impacts this disease.
Impact of exercise on breast cancer
Obesity and physical inactivity are responsible for both a higher risk of developing breast cancer and a higher risk of its relapse. The prevalence of inactivity has been estimated at 40% worldwide, forming a population segment for the development of breast cancer associated with physical inactivity of approximately 10%.
Exercise, in addition to contributing to the reduction of overall mortality and cardiovascular mortality, also protects against the risk of breast cancer and even improves its prognosis. It is estimated that 1 in 4 cases of breast cancer could be prevented with a healthy diet, weight control and physical activity. Over the past 20 years, more than 80 studies have been conducted evaluating the association between physical activity and cancer risk.
In a recent meta-analysis of 38 prospective cohort studies published between 1994 and 2017 in which 2.53 million women participated, including 68,416 cases of breast cancer, an inverse association between physical activity and the risk of breast cancer has been confirmed again. breast statistically significantly reduced by 13% (RR = 0.87; 95% CI: 0.84–0.90).
How much exercise should I do to reduce the risk of breast cancer?
Studies conducted to evaluate the impact of exercise on health measure physical activity in metabolic equivalents (METs), or METs/hours. For example, walking at a brisk pace (5 km/h for 1 hour) is equivalent to 3.5 MET/hour.
The reduction in cancer risk improves by increasing its intensity, that is, the number of MET-hours per week (around 3% for each increase of 10 MET/hour per week).
A case-control study demonstrated a risk reduction of up to 5%, reaching 12% in nulliparous women, for every 6 MET-hours/week.
In the guidelines of the “World Cancer Research Fund / American Institute for Cancer Research and American Cancer Society (2020) they recommend physical activity, sitting less. Perform aerobic exercise at least 150-300 minutes per week of moderate intensity, or 75-150 minutes per week of vigorous intensity. The US Dept of Health and Human Services (2018) recommends, in addition to the above, performing muscle strength and resistance training exercises for the main muscle groups at least two days a week.
Recommendations for physical activity after breast cancer
The majority of patients after suffering from cancer do not comply with the recommended physical exercise guidelines and many of them do not even do any free-time activities. However, evidence suggests that even mild-intensity physical activity can improve patients' physical fitness and functionality.
Some common impediments include not having time, not having an acceptable environment, uncertainty about the safety of exercise after adjuvant treatment or surgery, lack of knowledge regarding appropriate activities, and the presence of physical limitations secondary to cancer treatment.
Relieving pain, overcoming anxiety, and recovering nutritional deficits can make it easier to start a physical training program. Walking, swimming, or using a stationary bike are safe for virtually all patients.
Lymphedema is not a contraindication to physical exercise, and no special precautions are required for cardiovascular or aerobic exercise or muscular strength-endurance exercise of the unaffected extremities.
Patients are often advised to protect or avoid using the limb, which implies certain limitations in activities of daily living and often becomes an obstacle to exercising.
However, several randomized controlled studies have shown that resistance exercises such as lifting weights, slowly progressive and supervised, are safe for patients with breast cancer and do not worsen lymphedema compared to the control group.
In a systematic review of randomized controlled clinical trials that included more than 800 breast cancer survivors, a benefit from resistance exercise was shown with a significant improvement in muscle strength without an increase in lymphedema. Based on these data, progressive resistance training under supervision (2-3 non-consecutive days per week) is currently recommended as part of the treatment of patients with lymphedema.
Patients with peripheral neuropathy (adjuvant chemotherapy with taxanes), osteoporosis, arthritis, or musculoskeletal problems have a moderate risk of exercise injuries. Stability, balance and gait must be evaluated, choosing the most appropriate exercise based on the results; it is advisable to consider the assessment of specialized personnel (rehabilitator or physical trainer).
A possible strategy would be the initial prescription of physical activity of 1-3 sessions of light or moderate intensity of 20 minutes or more per week, with an individualized progression based on tolerance and adherence to the program until achieving what the guidelines recommend such as American Cancer Society (2010-2012), at least 150 minutes per week of moderate-intensity aerobic exercise, or 75 minutes of vigorous-intensity exercise per week with resistance exercises 2-3 weekly sessions that include the main muscle groups.
As has been shown, exercising is essential to have a healthy body and mind, with it you prevent the appearance of breast cancer and you can also improve your recovery prognosis. Dare to practice it and experience all these benefits!
Source: Santiago Escobar Gómez, mastólogo.
Astorga Oncology Clinic, always with you.
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