Numerous studies have shown that healthy lifestyle factors can reduce breast cancer recurrence and improve outcomes. Having a healthy lifestyle may also help alleviate some of the effects of breast cancer and its treatment.
Europa Donna is involved in research projects to gather more data on this topic and calls for more high-quality studies in this area.
Women who have had breast cancer should engage in regular, moderate exercise of at least 30-60 minutes per day.
There is consistent evidence from observational studies that physical activity is associated with reduced breast cancer specific mortality. Studies indicate that getting at least 2.5 hours of exercise per week reduces the likelihood of breast cancer recurrence and mortality.
Lifestyle factors to reduce the risk of recurrence: the St. Gallen Panel supported use of an exercise regimen and weight loss (or at least avoidance of weight gain). High levels of physical activity may improve survival in postmenopausal women with breast cancer, even among those reporting low physical activity prior to diagnosis.
Physical activity can also help to alleviate cancer-related side effects such as fatigue, and help to prevent lymphoedema, for example. A meta-analysis suggested that among breast cancer survivors receiving hormone therapy, a combination of aerobic and resistance exercise had positive effects on cardiorespiratory fitness and pain, although more high-quality research is needed.
In this regard, an ongoing project is examining the role of exercise in women with advanced breast cancer. The PREFERABLE (Project on Exercise for Fatigue Eradication in Advanced Breast cancer to improve quality of life) is aiming to generate solid and conclusive evidence of the beneficial effect of structured, individualized exercise on cancer-related side effects and patients’ quality of life.
For more information: https://www.h2020preferable.eu
The evidence for following a specific diet in order to reduce breast cancer recurrence is not conclusive, although many studies find that a Mediterranean diet that includes fish, olive oil, vegetables is desirable and that processed meat and red meat should be avoided.
Vitamin D should be included in the diet for women shown to be vitamin D deficient.
Obesity and BMI studies have shown that women who are obese are more likely to have a breast cancer recurrence and have poorer survival compared to those who maintain a normal body weight BMI less than 25. The effect of breast cancer treatments is lower in women who are obese than it those who are of normal weight.
Ballard-Barbash R, Friedenreich CM, Cournva KS et al. Physical activity biomarker and disease outcomes in cancer survivors: a systematic review. J Nat Cancer Institute 2012;104:815-840.
Boing L, Vieira MCS, Moratelli J, et al. Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy – A systematic review and meta-analysis. Maturitas. 2020;141:71-81.
Cannioto RA, Hutson A, Dighe S, et al. Physical activity before, during, and after chemotherapy for high-risk breast cancer: relationships with survival. J Natl Cancer Inst. 2021;113(1):54-63.
Chlebowski RT. Nutrition and physical activity influence on breast cancer incidence and outcome. The Breast 2013; 22 Suppl 2:S30-37.
Coates S, Winer EP, Goldhirsch A, et al. Tailoring therapies – improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Ann Oncol (2015) 26 (8): 1533-1546 first published online May 4, 2015.
Irwin ML, McTiernan A, Manson JE, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the Women’s Health Initiative. Cancer Prevention Res (Philadelphia, Pa). 2011;4(4):522-529.
Lee K, Kruper L, Dieli-Conwright CM, et al. The impact of obesity on breast cancer diagnosis and treatment. Curr Oncol Rep. 2019;21(5):41.
Protani M, Coory M, Martin JH, Effect of obesity on survival of women with breast cancer: systematic review and analysis. Breast Cancer Res Treat. 2010;123(3):627-35.