ArticleJournal of the National Cancer Institute2021
Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07107594 (Multimodal Intervention During Neoadjuvant Chemotherapy in Patients With Early-breast Cancer as a Strategy to Improve Treatment Response), which is not on this map. Cited by 121 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multimodal Intervention During Neoadjuvant Chemotherapy in Patients With Early-breast Cancer as a Strategy to Improve Treatment Response: DIANA Trial (Multimodal Prehabilitation: DIet, ANxiety Control Psychotherapy, Physical Activity)
Who cites it
121 citing papers in PubMed, 7 syntheses or guidelines pooled it, 182 citations in OpenAlex.
- Barriers to physical activity levels in people with cancer who are undergoing chemotherapy: a narrative systematic review with mapping to the capability, opportunity, motivation behaviour (COM-B) model.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Pooled it
- The Effects of Post-diagnosis Recreational Aerobic Exercise among Breast Cancer Survivors: A Systematic Review/Meta-Analysis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Pooled it
- Exercise and survival benefit in cancer patients: evidence from a comprehensive meta-analysis.GeroScience · 2025Pooled it
- Impact of Lifestyle Modifications on Cancer Mortality: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Effects of exercise interventions on breast cancer-related endogenous hormones in premenopausal and postmenopausal women: a systematic review and meta-analysis.Frontiers in physiology · 2025Pooled it
- Mobile Apps and Quality of Life in Patients With Breast Cancer and Survivors: Systematic Literature Review.Journal of medical Internet research · 2023Pooled it
- Postdiagnosis recreational physical activity and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis.International journal of cancer · 2023Pooled it
- 24-week home-based walking program in the early adjuvant setting in breast cancer patients who receive aromatase inhibitor endocrine therapy: lessons learned from the SAKK 95/17 WISE prospective, randomized, multicenter trial.Breast (Edinburgh, Scotland) · 2026Trial
- Trial
- Comparison of the effects of high-intensity interval and moderate-intensity continuous training on inflammatory markers, cardiorespiratory fitness, and quality of life in breast cancer patients.Journal of sport and health science · 2023Trial
- Patterns of Fitbit Use and Activity Levels Among African American Breast Cancer Survivors During an eHealth Weight Loss Randomized Controlled Trial.American journal of health promotion : AJHP · 2022Trial
- A longitudinal study of physical activity in patients with breast cancer: A latent transition analysis.Asia-Pacific journal of oncology nursing · 2026Article
- User Perspectives on a Clinical Decision Tool to Support Individualized Exercise Prescriptions for Breast Cancer Survivors Not Meeting Exercise Guidelines: Cross-Sectional Survey.JMIR formative research · 2026Article
- Exercise-related genes predicts overall survival and tumor immune microenvironment, and identifies the biological role of SLC52A2 in breast cancer.Discover oncology · 2026Article
- Contact with dogs is associated with improved survival in cancer patients.Scientific reports · 2026Article
- Leisure-Time Physical Activity and Cancer Mortality Among Cancer Survivors.JAMA network open · 2026Article
- Factors associated with programme completion and physical activity adherence in a community-based cancer exercise programme.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Stress Biology in Cancer: Neuroendocrine-Immune Mechanisms Linking Tumor Progression to Translational Interventions.Cancer communications (London, England) · 2026Review
- Article
- Multi-study R-learner for estimating heterogeneous treatment effects across studies using statistical machine learning.Biostatistics (Oxford, England) · 2025Article
61 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundAlthough physical activity has been consistently associated with reduced breast cancer mortality, evidence is largely based on data collected at one occasion. We examined how pre- and postdiagnosis physical activity was associated with survival outcomes in high-risk breast cancer patients.
methodsIncluded were 1340 patients enrolled in the Diet, Exercise, Lifestyle and Cancer Prognosis (DELCaP) Study, a prospective study of lifestyle and prognosis ancillary to a SWOG clinical trial (S0221). Activity before diagnosis, during treatment, and at 1- and 2-year intervals after enrollment was collected. Patients were categorized according to the Physical Activity Guidelines for Americans as meeting the minimum guidelines (yes/no) and incrementally as inactive, low active, moderately active (meeting the guidelines), or high active.
resultsIn joint-exposure analyses, patients meeting the guidelines before and 1 year after diagnosis experienced statistically significant reductions in hazards of recurrence (hazard ratio [HR] = 0.59, 95% confidence interval [CI] = 0.42 to 0.82) and mortality (HR = 0.51, 95% CI = 0.34-0.77); associations were stronger at 2-year follow-up for recurrence (HR = 0.45, 95% CI = 0.31 to 0.65) and mortality (HR = 0.32, 95% CI = 0.19 to 0.52). In time-dependent analyses, factoring in activity from all time points, we observed striking associations with mortality for low- (HR = 0.41, 95% CI = 0.24 to 0.68), moderate- (HR = 0.42, 95% CI = 0.23 to 0.76), and high-active patients (HR = 0.31, 95% CI = 0.18 to 0.53).
conclusionsMeeting the minimum guidelines for physical activity both before diagnosis and after treatment appears to be associated with statistically significantly reduced hazards of recurrence and mortality among breast cancer patients. When considering activity from all time points, including during treatment, lower volumes of regular activity were associated with similar overall survival advantages as meeting and exceeding the guidelines.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.