Bender Catherine M, Sereika Susan M, Gentry Amanda L, Zhu Yehui, Wagner Monica, Cuglewski Cheryl, Duquette Jennie, Grove George, Cummings Meredith, Cho Myeong-Ga, Brufsky Adam M, Diego Emilia J, McAuliffe Priscilla F, Marsland Anna L, Conley Yvette P, Erickson Kirk I
University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Support Care Cancer. 2025 Mar 4;33(3):244. doi: 10.1007/s00520-025-09257-4.
Women receiving aromatase inhibitors (AIs) for breast cancer frequently experience musculoskeletal symptoms (AIMS) including joint pain, stiffness, and muscle weakness. Aerobic exercise may reduce AIMS, but the evidence is inconclusive. This investigation examined whether aerobic exercise reduces pain in women with breast cancer.
Pain was a secondary outcome of a randomized controlled trial where postmenopausal women with breast cancer receiving AIs (N = 136) with or without pain were randomized to 6 months of moderate-intensity aerobic exercise (n = 70) or usual care (n = 66). The primary (Brief Pain Inventory severity, interference and worst pain) and secondary (SF-36 Bodily Pain and Breast Cancer Prevention Trial Symptom Checklist Musculoskeletal Pain) pain outcomes were assessed at pre-randomization (T1) and post-intervention (T2). Linear mixed modeling with linear contrasts was used to examine the effect of group assignment on outcomes.
Participants were a median = 4.7 months post-breast cancer diagnosis at T1. Group-by-time interactions were observed for pain severity ( = 0.848, 95% confidence interval (CI) = 0.233-1.464), pain interference ( = 0.997, 95% CI = 0.448-1.547), and worst pain ( = 1.371, 95% CI = 0.273-2.461) with significant increases in pain severity, interference, and worst pain in controls, small effect sizes, and no significant changes in the exercise group. We also found that a greater percentage of women in the control group had a clinically significant increase (≥ 2 points) in worst pain (p = 0.024) and pain severity (p = 0.029).
Our results suggest that aerobic exercise prevents pain increase and may reduce pain prevalence when initiated early in AI therapy. The trial was registered at Clinical Trials.gov (NCT02793921) on May 20, 2016.
Moderate-intensity aerobic exercise may prevent increases in pain and reduce pain when initiated early in AI therapy in postmenopausal women with breast cancer. Lack of exercise may be associated with increased over-the-counter pain medication use.
接受芳香化酶抑制剂（AI）治疗乳腺癌的女性经常会出现肌肉骨骼症状（AIMS），包括关节疼痛、僵硬和肌肉无力。有氧运动可能会减轻这些症状，但证据并不确凿。本研究旨在探讨有氧运动是否能减轻乳腺癌女性的疼痛。
疼痛是一项随机对照试验的次要结果，该试验将接受AI治疗的绝经后乳腺癌女性（N = 136），无论有无疼痛，随机分为6个月的中等强度有氧运动组（n = 70）或常规护理组（n = 66）。在随机分组前（T1）和干预后（T2）评估主要（简短疼痛量表的严重程度、干扰和最严重疼痛）和次要（SF-36身体疼痛和乳腺癌预防试验症状清单肌肉骨骼疼痛）疼痛结局。采用线性混合模型和线性对比来检验分组对结局的影响。
在T1时，参与者乳腺癌诊断后的中位时间为4.7个月。在疼痛严重程度（β = 0.848，95%置信区间（CI）= 0.233 - 1.464）、疼痛干扰（β = 0.997，95% CI = 0.448 - 1.547）和最严重疼痛（β = 1.371，95% CI = 0.273 - 2.461）方面观察到组间时间交互作用，对照组的疼痛严重程度、干扰和最严重疼痛显著增加，效应量较小，而运动组无显著变化。我们还发现，对照组中更大比例的女性最严重疼痛（p = 0.024）和疼痛严重程度（p = 0.029）有临床显著增加（≥2分）。
我们的结果表明，有氧运动可预防疼痛加剧，并在AI治疗早期开始时可能降低疼痛发生率。该试验于2016年5月20日在ClinicalTrials.gov注册（NCT02793921）。
中等强度有氧运动在绝经后乳腺癌女性AI治疗早期开始时，可能预防疼痛加剧并减轻疼痛。缺乏运动可能与非处方止痛药使用增加有关。
