Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trails

Guoqing Zhu, Xiao Zhang, Yulan Wang, Huizi Xiong, Yinghui Zhao, Fenyong Sun, Guoqing Zhu, Xiao Zhang, Yulan Wang, Huizi Xiong, Yinghui Zhao, Fenyong Sun

Abstract

Background: Exercise is associated with favorable outcomes in cancer survivors. The purpose of this meta-analysis is to comprehensively summarize the effects of exercise intervention in breast cancer survivors.

Methods: A systematic search of PubMed, Elsevier, and Google scholar was conducted up to March 2015. References from relevant meta-analyses and reviews were also checked.

Results: Thirty-three randomized controlled trials were included in this meta-analysis, including 2,659 breast cancer survivors. Compared with the control group, quality of life was significantly improved in exercise intervention group, especially in mental health and general health subscales of short form 36 questionnaire, as well as emotion well-being and social well-being subscales of the Functional Assessment of Cancer Therapy. Besides, exercise alleviated the symptoms of depression and anxiety in the exercise group. Furthermore, exercise was also associated with positive outcomes in body mass index, lean mass, and muscle strength. In addition, the serum concentration of insulin, insulin-like growth factor-II, and insulin-like growth factor binding protein-1 was significantly reduced in exercise intervention group. However, based on the current data of this meta-analysis, there were no significant differences in sleep dysfunction or fatigue between groups.

Conclusion: Our study suggested that exercise intervention was beneficial to breast cancer survivors. Therefore, exercise should be recommended to this patient group.

Keywords: BMI; depression; exercise; insulin; quality of life.

Figures

Figure 1
Figure 1
Flow diagram of study selection. Abbreviation: RCT, randomized controlled trial.
Figure 2
Figure 2
The association between exercise intervention and quality of life in breast cancer survivors. Notes: (A) SF-36 mental health, (B) SF-36 general health, (C) FACT emotion well-being, and (D) FACT social well-being. Abbreviations: CI, confidence interval; FACT, Functional Assessment of Cancer Therapy; SD, standard deviation; SF-36, short form 36 questionnaire; df, degree of freedom.
Figure 3
Figure 3
The association between exercise intervention and depression and anxiety in breast cancer survivors. Notes: (A) Depression and (B) anxiety. Abbreviations: CI, confidence interval; SD, standard deviation; df, degree of freedom.
Figure 4
Figure 4
The association between exercise intervention and body mass index in breast cancer survivors. Abbreviations: CI, confidence interval; SD, standard deviation; df, degree of freedom.
Figure 5
Figure 5
The association between exercise intervention and muscle strength in breast cancer survivors. Abbreviations: CI, confidence interval; SD, standard deviation; df, degree of freedom.
Figure 6
Figure 6
The association between exercise intervention and fatigue in breast cancer survivors. Notes: (A) Overall effect and (B) subgroup analysis based on the type of exercise intervention. Abbreviations: CI, confidence interval; FACIT, Functional Assessment of Chronic Illness Therapy; SD, standard deviation; df, degree of freedom.
Figure 7
Figure 7
The association between exercise intervention and insulin and IGFBP-1 in breast cancer survivors. Notes: (A) Insulin and (B) IGFBP-1. Abbreviations: CI, confidence interval; IFGBP-1, insulin-like growth factor binding protein-1; SD, standard deviation; df, degree of freedom.

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