The impact of breast cancer on physical activity from midlife to early older adulthood and predictors of change post-diagnosis

Publication Date


UMMS Affiliation

Graduate School of Nursing

Document Type



Neoplasms | Psychiatry and Psychology | Skin and Connective Tissue Diseases | Women's Health


PURPOSE: To examine physical activity (PA) patterns from pre- to post-diagnosis, and compare these changes to women without breast cancer. To determine pre-diagnosis predictors of PA change, post-diagnosis, in breast cancer survivors (BCS).

METHODS: Data were from 2314 Study of Women's Health Across the Nation (SWAN) participants, average age of 46.4 +/- 2.7 years at baseline (1996-1997). In Pink SWAN, 151 women who reported an incident breast cancer diagnosis over 20 years were classified as BCS; the remaining 2163 women were controls. LOESS plots and linear mixed models were used to illustrate and compare PA changes (sports/exercise [primary measure] and total PA) from pre- to post-diagnosis (or corresponding period) in BCS versus controls. Adjusted linear regression models were used to determine pre-diagnosis predictors of at-risk post-diagnosis PA change patterns (consistently low and decreased PA).

RESULTS: No differences in pre- to post-diagnosis PA (or corresponding period) were observed in BCS versus controls. Among BCS, the odds of at-risk post-diagnosis PA change patterns was 2.50 (95% CI 0.96-6.48) times higher for those who reported sleep problems at > /= 50% (compared to 0%) of pre-diagnosis visits and 3.49 (95% CI 1.26-9.65) times higher for those who were overweight or obese at all (compared to no) pre-diagnosis visits. No other statistically significant predictors were noted.

CONCLUSIONS: Age-related declines in PA were not amplified by a breast cancer diagnosis. Given the beneficial role of PA across the cancer control continuum, efforts to increase or maintain adequate PA, post-diagnosis, should be continued.

IMPLICATIONS FOR CANCER SURVIVORS: While age-related physical activity declines were not amplified breast cancer diagnosis, efforts to identify breast cancer survivors at increased risk for post-diagnosis physical activity declines (or maintenance of low activity) may be a high-yield strategy to improve prognosis and quality of life.


Breast cancer, Cohort studies, Exercise, Survivorship

DOI of Published Version



Pettee Gabriel K, Sternfeld B, Colvin AB, Lucas AR, Karvonen-Gutierrez CA, Gold EB, Crawford S, Greendale GA, Avis NE. The impact of breast cancer on physical activity from midlife to early older adulthood and predictors of change post-diagnosis. J Cancer Surviv. 2020 Aug;14(4):545-555. doi: 10.1007/s11764-020-00879-7. Epub 2020 Mar 30. PMID: 32232722; PMCID: PMC7365759. Link to article on publisher's site

Journal/Book/Conference Title

Journal of cancer survivorship : research and practice

Related Resources

Link to Article in PubMed

PubMed ID