Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Physical Functioning in Older Patients With Breast Cancer: A Prospective Cohort Study in the TEAM Trial. Physical activity and psychosocial benefits among breast cancer patients. Physical Activity and Survival after Diagnosis of Invasive Breast Cancer Quality of life among younger women with breast cancer: study from a tertiary cancer institute in south India. Physical Functioning: Effect of Behavioral Intervention for Symptoms Among Individuals With Cancer Physical activity during and after adjuvant chemotherapy in patients with breast cancer. Physical Activity in Relation to Mammographic Density in the Dutch Prospect-European Prospective Investigation into Cancer and Nutrition Cohort Physical activity in usual occupation and risk of breast cancer (United States) The usefulness of a multidisciplinary educational programme after breast cancer surgery: a prospective and comparative study. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. A randomized trial to increase physical activity in breast cancer survivors. Long-term prognostic role of functional limitations among women with breast cancer. A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial The association between physical activity and health-related quality of life among breast cancer survivors Maintenance of physical activity and body weight in relation to subsequent quality of life in postmenopausal breast cancer patients.
Purpose Breast cancer patients often experience a decline in physical functioning following cancer diagnosis . Although most patients recover after treatment , some patients do not . These changes may be magnified in older women with comorbid conditions and could impact survival outcomes . Methods We used longitudinal data from a prospect i ve cohort study of women 65 + years of age , recruited shortly after diagnosis of early stage breast cancer , to examine changes in self-reported physical functioning measured with the  Physical Function Index ( PF-10 ) of the Medical Outcomes Study Short Form-36 . Outcomes were constructed for small ( 0.2 SD ) , medium ( 0.5 SD ) , and large ( 0.8 SD ) declines in the PF-10 measurement over two intervals : ( 1 ) 3 to 15 months following cancer diagnosis , encompassing treatment and early recovery , and ( 2 ) 3 to 27 months following cancer diagnosis , in order to detect sustained recovery versus persistent decline . Cox-proportional hazards regression was used to examine association between survival and decline in PF-10 scores . Results A large ( > 0.8 SD ) decline in PF-10 scores from 3 to 27 months predicted shorter 10-year survival ( hazard ratio = 1.34 , 95 % confidence interval 1.1–1.6 ) . Persistent decline at 27 months was associated with less education , higher baseline PF-10 , increased comorbidity , and higher body mass index . Conclusions Older women with breast cancer who experience a large and persistent decline in PF-10 are at increased mortality risk . Future research should examine the value of clinical assessment of physical function as a marker for mortality and test interventions to prevent decline in physical function to improve post-treatment survival outcomes . Implication s for Cancer SurvivorsMany breast cancer survivors experience a decline in physical functioning in the year following their cancer diagnosis . While the majority of patients recover in the year after treatment is completed , individuals who experience a persistent decline in physical functioning without recovery are at risk of functional decline and early mortality . Our results highlight the importance of assessing functional status to identify those at risk for functional decline , and suggest a potential role for early intervention in these individuals The goal of this study was to identify distinct trajectories of adjustment to breast cancer over 4 years as well as to distinguish among the different trajectories . The mental and physical functioning of 287 women with breast cancer who remained alive and disease free through 4 years of follow-up were examined . The majority of women showed slight and steady improvement in functioning with time , but subgroups of women were identified who showed marked improvement and marked deteriorations over time . Age successfully distinguished different trajectories of physical functioning . Indices of  personal  re sources ( i.e. , self-image , optimism , perceived control ) and social re sources ( i.e. , social support ) successfully distinguished different courses of mental and physical functioning BACKGROUND Previous retrospective studies have shown that physical functioning in older cancer survivors is affected after treatment , yet prospect i ve data are lacking . The aim of this study was to assess change in physical functioning in different age groups of patients with hormone receptor-positive breast cancer who were enrolled in the Tamoxifen Exemestane Adjuvant Multinational ( TEAM ) phase III trial . METHODS Two physical parameters were assessed . Physical functioning was assessed using the European Organisation for Research and Treatment of Cancer ( EORTC ) QLQ-C30 question naire 1 year ( T1 ) and 2 years ( T2 ) after diagnosis . Physical activity was measured in metabolic equivalent of task ( MET ) hours/week at T1 and T2 .  Physical activity  before diagnosis ( T0 ) was assessed retrospectively at the T1 question naire . Patients were divided into three age groups : < 60 , 60 - 69 , and ≥70 years . Decline in physical functioning was assessed using linear regression analysis . Differences in mean values of physical activity levels were calculated using repeated- measures one-way analysis of variance . RESULTS A total of 431 patients were included for analysis . In all age groups , physical activity levels at T1 and T2 were significantly lower than prediagnostic physical activity levels ( T0 ) ( p < .001 for all age groups ) . Age ≥70 years was independently associated with decline in physical functioning between T1 and T2 ( β = -4.62 , 95 % confidence interval -8.73 to -0.51 , p = .028 ) . CONCLUSION Patients aged 70 years or older treated with breast surgery and adjuvant hormonal therapy  did not improve between years 1 and 2 after diagnosis to the same extent as did younger patients . IMPLICATION S FOR PRACTICE Although older patients constitute a large share of the breast cancer population , little is known about the effect and consequences of treatment of breast cancer in this specific age group . This study revealed that , unlike younger patients , older patients do not regain their physical abilities  after surgical and adjuvant treatment for breast cancer . In older adults , the effect of treatment on physical functioning and independency could be more relevant than survival outcomes . Clinicians and older patients should be aware of the impact of treatment on physical functioning and prevent older patients from experiencing physical decline , which could lead to institutionalization and loss of independence . There is a need for age-specific guidelines that take into account the heterogeneity of the older population and for evidence -based treatment that focuses not only on cancer-specific outcomes but also on the consequences of treatment for physical and cognitive functioning and quality of life OBJECTIVE Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology healthcare provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . Our goal in this secondary analysis was to examine the amount of PA ( min/week ) needed for psychosocial benefits among both groups . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : mean = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to  telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , fatigue , physical functioning , and quality of life were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . A non-r and omized design was used to examine the dose-response relationship between PA and psychosocial outcomes . RESULTS Exercising for at least 150 min/week at moderate intensity was associated with improved physical functioning ( b = 5.9 , SE = 2.9 , p = 0.04 ) and quality of life ( b = 3.6 , SE = 1.9 , p = 0.05 ) at 3 months . These relationships were not found at 6 and 12 months ( p 's > 0.05 ) . However , women who reported at least 150 min/week of PA at both 3 and 6 months had significantly reduced fatigue ( b = 1.3 , SE = 0.7 , p = 0.05 ) and improved physical functioning ( b = 3.1 , SE = 1.3 , p = 0.02 ) and quality of life ( b = 2.0 , SE = 0.9 , p = 0.02 ) compared with women who did not meet this criterion . CONCLUSION Women who exercised at recommended levels ( at least 150 min/week ) and sustained this level of activity for at least 6 months accrued psychosocial benefits Previous studies suggest that increased physical activity may lower the risk of breast cancer incidence , but less is known about whether levels of physical activity after breast cancer diagnosis can influence survival . We prospect ively examined the relation between postdiagnosis recreational physical activity and risk of breast cancer death  in women who had a previous invasive breast cancer diagnosed between 1988 and 2001 ( at ages 20 - 79 years ) . All women completed a question naire on recent  postdiagnosis physical activity and other lifestyle factors . Among 4,482 women without history of recurrence at the time of completing the question naire , 109 died from breast cancer within 6 years of enrollment .  Physical activity was expressed as metabolic equivalent task-hours per week ( MET-h/wk ) ; hazard ratios ( HR ) and 95 % confidence intervals ( 95 % CI ) were estimated using Cox proportional hazards regression . After adjusting for age at diagnosis , stage of disease , state of residence , interval between diagnosis and physical activity assessment , body mass index , menopausal status , hormone therapy use , energy intake , education , family history of breast cancer , and treatment modality compared with women expending < 2.8 MET-h/wk in physical activity , women who engaged in greater levels of activity had a significantly lower risk of dying from breast cancer ( HR , 0.65 ; 95 % CI , 0.39 - 1.08 for 2.8 - 7.9 MET-h/wk ; HR , 0.59 ; 95 % CI , 0.35 - 1.01 for 8.0 - 20.9 MET-h/wk ; and HR , 0.51 ; 95 % CI , 0.29 - 0.89 for ≥21.0 MET-h/wk ; P for trend = 0.05 ) . Results were similar for overall survival ( HR , 0.44 ; 95 % CI , 0.32 - 0.60 for ≥21.0 versus < 2.8 MET-h/wk ; P for trend < 0.001 ) and were similar regardless of a woman ’s age , stage of disease , and body mass index . This study provides support for reduced overall mortality and mortality from breast cancer among women who engage in physical activity  after breast cancer diagnosis . ( Cancer Epidemiol Biomarkers Prev 2008;17(2):379–86 BACKGROUND The incidence of breast cancer in young patients less than 35 years is less than 1 % . The physical and psychosocial morbidity may affect their ability to successfully function in their social roles . Hence we studied the  quality of life ( QOL )  issues in this subset . MATERIAL S AND METHODS Younger women with age less than 35 years , diagnosed with non-metastatic breast cancer at our Institute , from 1995 to 2005 , were included in the study .  Quality of life issues were studied during the follow-up using EORTC QOL C30 and BR23 . Descriptive and inferential statistics were used in order to analyze the data . RESULTS A total of 51 patients were included for the study . The mean age at diagnosis was 30 years . The effect of breast cancer on the occupation and marital status was minimal . The global health status and the functional scores were high , while the overall sexual function was lower . The global health status was higher in the mastectomy group . The arm symptoms ( P = 0.027 ) and pain were higher in the Breast conservation surgery ( BCS ) group . The sexual symptoms appeared to be higher in the ovary ablated group when compared to the ovary preserved group . The sexual functional scores ( P = 0.02 ) and sexual enjoyment scores ( P = 0.003 ) were better in the mastectomy group . CONCLUSION The overall QOL in younger patients with breast cancer appeared to be good . The QOL and sexual function were marginally worse in the breast conservation group when compared to mastectomy group Background : Individuals with cancer receiving chemotherapy suffer deterioration in physical functioning due to symptoms arising from the cancer disease process and its treatment . Objectives : To determine if age , chronic health conditions ( comorbidity ) , stage of cancer , depressive symptomatology , symptom limitations , sex , and site of cancer moderate the effects of cognitive behavioral intervention on physical function and to determine if symptom limitations mediate the effect of the intervention on physical functioning . Methods : Two hundred thirty-seven individuals with solid tumor cancer ( 118 experimental and 119 control group ) participated in this 10-contact , 18-week r and omized control trial . Cognitive behavioral theory guided the nurse-delivered problem-solving experimental intervention . The control group received conventional care . Interviews occurred at baseline and 10 , 20 , and 32 weeks . Results : Women with breast cancer had significantly better physical functioning than women with lung cancer . Chronic health conditions , symptom limitation , and depressive symptomatology at baseline were found to moderate the effect of intervention on physical function . Symptom limitation , however , was not found to mediate the effect of intervention on physical functioning . Discussion : The intervention was shown to affect physical function trajectories differently for individuals with different personal and health characteristics . Because poor physical functioning is strongly associated with mortality and poor quality of life , this information may be used by health professionals to target interventions to those who might be most responsive OBJECTIVES To describe changes in physical activity levels related to health-enhancing physical activity guidelines during and after adjuvant chemotherapy in a cohort of Swedish patients with breast cancer . DESIGN Exploratory clinical prospect i ve longitudinal study with 6 and 12 months of follow-up . PARTICIPANTS Forty women treated for breast cancer with adjuvant chemotherapy were included , and 33 women completed the study . MAIN OUTCOME MEASURES The primary outcome was the proportion of participants meeting the health-enhancing physical activity guidelines , both in relative terms ( perceived exertion using Borg 's rate of perceived exertion scale ) and absolute terms ( metabolic equivalent ) . RESULTS The proportion of participants meeting the guidelines when leisure-time physical activity was measured in terms of absolute intensity was 81 ( 25/31 ) to 94 % ( 31/33 ) during chemotherapy , 93 % ( 29/31 ) at 6-month follow-up and 87 % ( 26/30 ) at 12-month follow-up . Women who had been physically active before their cancer diagnosis and women who had received information about physical activity were more physically active during chemotherapy . CONCLUSIONS Swedish patients with breast cancer are generally more physically active during adjuvant chemotherapy than has been reported previously in international studies . Physical activity habits prior to cancer diagnosis and information about the benefits of physical activity appear to be important factors for higher levels of physical activity during and after chemotherapy Background : Evidence accumulates that physical inactivity is one of the few modifiable risk factors for breast cancer . The mechanism through which physical inactivity affects breast cancer risk is not clear . The study aim was to investigate the association between physical activity and breast density because mammographic density is strongly associated with breast cancer risk . Methods : We did a cross-sectional study in 620 women , of ages 49 to 68 years and participants of the Dutch Prospect -European Prospect i ve Investigation into Cancer and Nutrition cohort . A self-administered question naire was used to obtain information on duration and intensity of physical activity ( recreational , household , and occupational ) during the year preceding study recruitment . A total activity index ( inactive , moderately inactive , moderately active , and active ) was estimated by combining all activity types . Percent and absolute breast density were determined on screening mammograms using a computer-aided method . Multivariate linear regression was used to examine the association between physical activity and breast density . Results : Mean percent density was 35.3 % [ 95 % confidence interval ( 95 % CI ) , 31.8 - 38.8 ] for the inactive category compared with 36.1 % ( 95 % CI , 33.0 - 39.2 ) for the active category . Mean absolute density values for the inactive and active category were 45.8 cm2 ( 95 % CI , 40.9 - 50.7 ) and 42.6 cm2 ( 95 % CI , 38.3 - 47.0 ) , respectively . Subgroup analysis for postmenopausal women showed similar results , as did separate analyses for recreational and household activity . Conclusions : The result does not support a relation between current physical activity and mammographic density in postmenopausal women . ( Cancer Epidemiol Biomarkers Prev 2006;15(3):456–60 We have used data from a large population -based case-control study inthe United States to evaluate the effect of occupational physical activity onbreast  cancer risk . Women diagnosed with breast cancer identified from fourstate cancer registries , and controls r and omly selected from lists oflicensed drivers or Medicare beneficiaries , were interviewed by telephone forinformation on usual occupation and other factors . We classified usualoccupation into one of four categories of physical activity . After excludingsubjects for whom a strength rating could not be assigned , we had a final sample size of 4,863 cases and 6,783 controls . Using conditional logisticregression models , we calculated adjusted odds ratios ( OR ) and 95 percentconfidence intervals ( CI ) for occupations having light , medium , and heavyactivity compared with sedentary ones . Women with heavy-activity occupationshad a lower risk of breast cancer than women with sedentary jobs ( OR = 0.82,CI = 0.63 - 1.08 ) , as di d women with jobs with medium activity ( OR = 0.86 , CI= 0.77 - 0.97 ) or light activity ( OR = 0.92 , CI = 0.84 - 1.01 ) . There was asignificant decreasing trend in the ORs from sedentary to heavy work ( P = 0.007 ) . Although limited by exposure misclassification , these data areconsistent with the hypothesis that physical activity reduces the risk ofbreast cancer The aim of the study was to compare and evaluate a multidisciplinary educational programme with traditional follow-up visits to a physician after breast cancer surgery in terms of well-being , aspects of self-care and coping ability 1 year after diagnosis . A reduction in the intensity of follow-up after breast cancer surgery is recommended . New follow-up models are being debated and could be of interest . The study design was non-r and omised and comparative . Ninety-six consecutively selected women with newly diagnosed breast cancer , classified as stage I or stage II , participated in either a multidisciplinary educational programme ( n=50 ) , or traditional follow-up by a physician ( n=46 ) . Three question naires were used : Functional Assessment of Cancer Therapy-General ( FACT-G ) , a study specific question naire regarding self-care aspects ( SCA ) and Sense of Coherence ( SOC ) . With the exception of physical well-being at baseline there was no significant difference between the groups . The women in the multidisciplinary educational programme increased their physical and functional well-being ( P<0.01 ) . The women in traditional follow-up by a physician increased their functional well-being while social/family well-being ( P<0.01 ) decreased over time . There was a statistically significant difference in SOC ( P<0.001 ) in the traditional follow-up by a physician between baseline ( mean=74.4 , SD=12.4 ) and the 1-year follow up ( mean=67.7 , SD=11.4 ) . Thus , women in the traditional follow-up by a physician scored lower in the area of SOC 1 year after diagnosis . A multidisciplinary educational programme may be an alternative to traditional follow-up by a physician after breast cancer surgery , but more research is needed about the financial benefits and effectiveness of such a programme BACKGROUND During the last decade , survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy . Limited data exist on the psychosocial aspects of the transitional period between the end of primary treatment and survivorship . We investigated the baseline psychosocial status of women enrolled in a r and omized trial testing two psychosocial interventions for women at the end of primary treatment . METHODS Participants , identified within 1 month after surgery ( registration ) , provided demographic information and limited measures of quality of life . They were followed until they finished primary treatment ( enrollment ) , at which time they completed a mailed baseline survey that included st and ardized measures of quality of life ( including st and ardized scales of physical and emotional functioning ) , mood , symptoms , and sexual functioning .  A total of 558 patients ( mean age = 56.9 years ) were enrolled in the study between July 1 , 1999 , and June 30 , 2002 . Health outcomes were examined according to treatment received : mastectomy with and without chemotherapy , and lumpectomy with and without chemotherapy . All statistical tests were two-sided . RESULTS Among all treatment groups , patients who had a mastectomy had the poorest physical functioning at registration ( P<.001 ) and at enrollment ( P=.05 ) . At enrollment , mood and emotional functioning were similar among all patients , with no differences by type of treatment received . At enrollment , symptoms , including muscle stiffness , breast sensitivity , aches and pains , tendency to take naps , and difficulty concentrating , were common among patients in all groups and were statistically significantly associated with poor physical functioning and emotional well-being . Sexual functioning was worse for women who received chemotherapy than for those who did not , regardless of type of surgery ( P<.001 ) . CONCLUSIONS At the end of primary treatment for breast cancer , women in all treatment groups report good emotional functioning but report decreased physical functioning , particularly among women who have a mastectomy or receive chemotherapy . Clinical interventions to address common symptoms associated with treatment should be considered to improve physical and emotional functioning at the end of primary treatment for breast cancer PURPOSE Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality . Therefore , we report the feasibility and preliminary outcomes of a pilot r and omized trial design ed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy . METHODS Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I , II , or IIIA breast cancer were r and omly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care . RESULTS Recruitment was 34 % , intervention adherence was 99 % , and complete follow-up data were obtained on 93 % . Most participants ( 93 % ) were white with mean age of 53 + /- 9 yr . Differences favoring the intervention group were noted for accelerometer physical activity counts ( mean difference = 72,103 ; 95 % confidence interval ( CI ) = 25,383 - 119,000 ; effect size ( d ) = 1.02 ; P = 0.004 ) , aerobic fitness ( mean difference = 2.9 ; 95 % CI = -0.1 to 5.8 ; d = 0.64 ; P = 0.058 ) , back/leg muscle strength ( mean difference = 12.3 ; 95 % CI = 0.4 - 15.9 ; d = 0.81 ; P = 0.017 ) , waist-to-hip ratio ( mean difference = -0.05 ; 95 % CI = -0.01 to -0.08 ; d = -0.77 ; P = 0.018 ) , and social well-being ( mean difference = 2.0 ; 95 % CI = 0.3 - 3.8 ; d = 0.76 ; P = 0.03 ) . However , the intervention group also reported a greater increase in joint stiffness ( mean difference = 1.1 ; 95 % CI = 0.1 - 2.2 ; d = 0.70 ; P = 0.04 ) . CONCLUSIONS A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes . Confirmation in a larger study is warranted BACKGROUND The long-term prognostic role of functional limitations among women with breast cancer is poorly understood . METHODS We studied a cohort of 2202 women with breast cancer at two sites in the United States , who provided complete information on body functions involving endurance , strength , muscular range of motion , and small muscle dexterity following initial adjuvant treatment .  Associations of baseline functional limitations with survival were evaluated in delayed entry Cox proportional hazards models , with adjustment for baseline sociodemographic factors , body mass index , smoking , physical activity , comorbidity , tumor characteristics , and treatment . Difference in covariates between women with and without limitations was assessed with Pearson χ(2 ) and Student t tests . All statistical tests were two-sided . RESULTS During the median follow-up of 9 years , 112 deaths were attributable to competing causes ( 5 % of the cohort ) and 157 were attributable to breast cancer causes ( 7 % of the cohort ) . At least one functional limitation was present in 39 % of study participants . Proportionately , more breast cancer patients with functional limitations after initial adjuvant treatment were older , less educated , and obese ( P < .001 ) . In multivariable models , functional limitations were associated with a statistically significantly increased risk of death from all causes ( hazard ratio [ HR ] = 1.40 , 95 % confidence interval [ CI ] = 1.03 to 1.92 ) and from competing causes ( HR = 2.60 , 95 % CI = 1.69 to 3.98 ) but not from breast cancer ( HR = 0.90 , 95 % CI = 0.64 to 1.26 ) . The relationship between functional limitations and overall survival differed by tumor stage ( among women with stage I and stage III breast cancer , HR = 2.02 , 95 % CI = 1.23 to 3.32 and HR = 0.74 , 95 % CI = 0.42 to 1.30 , respectively ) . CONCLUSION In this prospect i ve cohort study , functional limitations following initial breast cancer treatment were associated with an important reduction in all-cause and competing-cause survival , irrespective of clinical , lifestyle , and sociodemographic factors Objectives This study aim ed to determine the effect of a moderate , tailored exercise program on health-related quality of life , physical function , and arm volume in women receiving treatment for nonmetastatic breast cancer . Methods Women who were within 4–12 weeks of surgery for stage I – III breast cancer were r and omized to center-based exercise and lymphedema education intervention or patient education .  Functional Assessment of Cancer Therapy – Breast Cancer ( FACT-B ) , 6-min walk , and arm volume were performed at 3-month intervals through 18 months . Repeated measures analysis of covariance was used to model the total meters walked over time , FACT-B scores , and arm volume . Models were adjusted for baseline measurement , baseline affected arm volume , number of nodes removed , age , self-reported symptoms , baseline SF-12 mental and physical component scores , visit , and treatment group . Results Of the recruited 104 women , 82 completed all 18 months . Mean age ( range ) was 53.6 ( 32–82 ) years ; 88 % were Caucasian ; 45 % were employed full time ; 44 % were overweight ; and 28 % obese . Approximately , 46 % had breast-conserving surgery ; 79 % had axillary node dissection ; 59 % received chemotherapy ; and 64 % received radiation . The intervention result ed in an average increase of 34.3 ml ( SD = 12.8 ) versus patient education ( p = 0.01 ) . Changes in FACT-B scores and arm volumes were not significantly different . Conclusions With this early exercise intervention after breast cancer diagnosis , a significant improvement was achieved in physical function , with no decline in health-related quality of life or detrimental effect on arm volume . Implication s for cancer survivorsStarting a supervised exercise regimen that is tailored to an individual 's strength and stamina within 3 months following breast cancer surgery appears safe and may hasten improvements in physical functioning Background The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy . The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life ( HRQOL ) in breast cancer survivors . Methods We conducted a cross-sectional study of breast cancer survivors . A total of 231 women aged 21–78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study . We asked participants about their HRQOL and engagement in physical activity using structured question naires . We examined the association between HRQOL levels and physical activity using a generalized linear model . Results Breast cancer survivors in the high physical activity group ( 3rd tertile ) were more likely to have lower scores for fatigue ( p for trend = 0.001 ) and pain ( p for trend = 0.02 ) and higher scores for sexual function ( p for trend = 0.007 ) than those in the low physical activity group ( 1st tertile ) . When we stratified participants by stage , we found increasing scores for physical functioning ( p for trend = 0.01 ) and decreasing scores for fatigue ( p for trend = 0.02 ) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer . In survivors with stages II and III , we found statistically significant associations with fatigue ( p for trend = 0.02 ) and sexual functioning ( p for trend = 0.001 ) . Conclusions In conclusion , engagement in physical activity was related to better health-related quality of life among breast cancer survivors . Our findings may warrant further prospect i ve and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors BACKGROUND We prospect ively examined the association between physical activity , body weight and quality of life in Dutch postmenopausal early breast cancer patients treated with adjuvant endocrine therapy .  PATIENTS AND METHODS In this side study of a large clinical trial , lifestyle and quality -of-life question naires were filled out 1 and 2 years after the start of endocrine therapy ( T1 and T2 , respectively ) and included a pre-diagnosis lifestyle assessment ( T0 ) . A total of 435 breast cancer patients returned both question naires . RESULTS Individuals with a physical activity level above the median who maintained this level from T0 to T1 reported the best global quality of life and physical functioning and the least fatigue at T2 , as compared with individuals with low levels of physical activity which further decreased after diagnosis ( difference of + 16 , + 14 , and -22 points on a 0 - 100 quality -of-life scale , respectively ; P < 0.01 ) . Overweight or obese women who gained body weight after diagnosis reported worst quality of life and most fatigue as compared with women who maintained a stable body weight ( difference of -8 , -10 and + 2 points , respectively ; P < 0.01 ) . CONCLUSION Maintaining high pre-diagnosis physical activity levels and a healthy body weight is associated with better quality of life after breast cancer
Aerobic fitness values were generally below average , although 6-minute walk time was closer to population norms .
Upper and lower extremity strength was lower than population norms for women who were currently receiving cancer treatment .
Lower extremity strength was above population norms for women who had completed treatment .
Aerobic capacity and upper extremity strength in women diagnosed with breast cancer are generally lower than population norms .
QUESTION What are typical values of physical function for women diagnosed with breast cancer and how do these compare to normative data ?