Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy - A systematic review and meta-analysis

Maturitas. 2020 Nov:141:71-81. doi: 10.1016/j.maturitas.2020.06.022. Epub 2020 Jun 26.

Abstract

Background: Side-effects of hormone therapy can impair the physical health of breast cancer survivors. Exercise has been clearly shown to improve the quality of life of breast cancer survivors. Less is known about the effects of exercise on physical outcomes for breast cancer survivors receiving hormone therapy.

Objective: To investigate the effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy.

Methods: Five electronic databases were searched by two authors using the terms "Breast Neoplasms" [MeSH] and "Tamoxifen" [MeSH] and "Aromatase Inhibitors" [MeSH] and "Exercise" [MeSH]. Randomized and non-randomized clinical trials were included. Risk of bias was assessed by the Cochrane Collaboration tool and ROBINS-I, and the quality of evidence was evaluated using GRADE. Pooled effects were reported as standardized mean differences (SMDs) and 95 % confidence intervals (CIs) using a random effects model.

Results: Eleven studies were included in the meta-analysis. Two hundred and fourteen breast cancer survivors receiving hormone therapy, tamoxifen, or aromatase inhibitors participated in interventions based on aerobic plus resistance exercise or walking activity. The physical outcomes reported in the articles were: cardiorespiratory fitness, pain, bone mineral density, grip strength, and body fat percentage. Exercise effects were found only for cardiorespiratory fitness (SMD = 0.37; 95 % CI: 0.11; 0.63; I2 = 93 %) and pain (SMD = -0.55; IC95 % -1.11; -0.00; I2 = 80 %), with low quality of evidence. No effects were observed for the other variables.

Conclusions: Aerobic plus resistance exercise had positive effects on cardiorespiratory fitness and pain in breast cancer survivors receiving hormone therapy. However, high-quality randomized clinical trials are required to confirm this finding.

Keywords: Aromatase inhibitors; Breast neoplasms; Exercise; Tamoxifen.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antineoplastic Agents, Hormonal / adverse effects*
  • Aromatase Inhibitors / adverse effects*
  • Bone Density
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / rehabilitation*
  • Cancer Survivors*
  • Exercise Therapy
  • Exercise*
  • Female
  • Humans
  • Quality of Life
  • Survivors
  • Tamoxifen / adverse effects*
  • Walking

Substances

  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Tamoxifen