Oncology Center, International Medical Center, PO Box 2172, Jeddah, 21451, Kingdom of Saudi Arabia,
Med Oncol. 2011 Sep;28(3):753-65. doi: 10.1007/s12032-010-9536-x. Epub 2010 Apr 22.
Published data have shown that physical activity (PA) has a positive role on the primary prevention of breast cancer risk. However, the role of PA on breast cancer outcome has been controversial with inconsistent data. The lack of a meta-analysis that addresses that issue prompted the current report. A comprehensive literature search identified eight studies, of which two studies were excluded. The remaining six studies (12,108 patients with breast cancer) were included in this meta-analysis. Pre-diagnosis PA reduced all causes mortality by 18% but had no effect on breast cancer deaths. Post-diagnosis PA reduced breast cancer deaths by 34% (HR=0.66, 95% CI, 0.57-0.77, P<0.00001), all causes mortality by 41% (HR=0.59, 95% CI, 0.53-0.65, P<0.00001), and disease recurrence by 24% (HR=0.76, 95% CI, 0.66-0.87, P=0.00001). Breast cancer mortality was reduced by pre-diagnosis PA in women with body mass index (BMI)<25 kg/m2, while post-diagnosis PA reduced that risk among those with BMI≥25 kg/m2. On the other hand, post-diagnosis PA reduced all causes mortality regardless of the BMI. The analysis showed that post-diagnosis PA reduced breast cancer deaths (HR=0.50, 95% CI, 0.34-0.74, P=0.0005), and all causes mortality (HR=0.36, 95% CI, 0.12-1.03, P=0.06) among patients with estrogen receptor (ER)-positive tumor, while women with ER-negative disease showed no gain. The current meta-analysis provides evidence for an inverse relationship between PA and mortality in patients with breast cancer and supports the notion that appropriate PA should be embraced by breast cancer survivors.
已发表的数据表明，身体活动（PA）对乳腺癌风险的一级预防有积极作用。然而，PA 对乳腺癌结局的作用一直存在争议，数据也不一致。缺乏针对这一问题的荟萃分析促使我们撰写了本报告。全面的文献检索确定了八项研究，其中两项研究被排除在外。其余六项研究（12108 例乳腺癌患者）纳入本荟萃分析。诊断前的 PA 可使全因死亡率降低 18%，但对乳腺癌死亡无影响。诊断后的 PA 可使乳腺癌死亡降低 34%（HR=0.66，95%CI，0.57-0.77，P<0.00001），全因死亡率降低 41%（HR=0.59，95%CI，0.53-0.65，P<0.00001），疾病复发率降低 24%（HR=0.76，95%CI，0.66-0.87，P=0.00001）。诊断前的 PA 可降低 BMI<25kg/m2 的女性的乳腺癌死亡率，而诊断后的 PA 则降低了 BMI≥25kg/m2 的女性的乳腺癌死亡率风险。另一方面，诊断后的 PA 降低了全因死亡率，与 BMI 无关。分析表明，诊断后的 PA 降低了乳腺癌死亡（HR=0.50，95%CI，0.34-0.74，P=0.0005）和全因死亡率（HR=0.36，95%CI，0.12-1.03，P=0.06），而 ER 阴性疾病的女性则无获益。本荟萃分析为 PA 与乳腺癌患者死亡率之间的反比关系提供了证据，并支持适当的 PA 应被乳腺癌幸存者所接受的观点。
