Physical exercise might modulate the upregulation of immune and inflammatory-pathways involved in breast cancer, according to findings presented at the 2016 San Antonio Breast Cancer Symposium.1

“A brief, preoperative exercise intervention led to upregulation in pathways including cytokine-cytokine receptor interaction and immune pathways,” reported Jennifer A. Ligibel, MD, of the Susan F. Smith Center for Women’s Cancers at the Dana-Farber Cancer Institute in Boston, Massachusetts. “These findings demonstrate that exercise may have a direct effect on breast tumor tissue in humans, providing new insights into the biologic mechanisms through which exercise could affect cancer.”

Eighteen gene pathways were upregulated in the physical exercise study group compared to none in the mind-body program control group. The affected pathways were consistent with those previously noted in animal models, Dr Ligibel noted.

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Affected pathways included natural killer cell mediated cytotoxicity, antigen processing and presentation, and T cell receptor signaling pathways.

But no individual genes exhibited significant differential upregulation in multivariate analysis.

The findings were preliminary, based on a small and heterogenous patient sample and short intervention duration, she cautioned. A total of 26 women with newly-diagnosed stage I-III breast cancer not undergoing neoadjuvant therapies or taking hormone or diabetes medications for other indications were randomly assigned to the exercise study group. Twenty-two patients were randomly assigned to the mind-body control group.

The exercise intervention involved supervised, “moderate-intensity” physical activity twice weekly plus home-based aerobic exercise, with the goal of 180 minutes of aerobic activity and 40 minutes of strength training per week. The mind-body intervention involved daily self-guided visualization exercises.

“The period between enrollment and surgery varied from 2 to 9 weeks, so patients participated in interventions for different amounts of time,” she cautioned.

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“These findings need to be validated in additional cohorts, and future work is needed correlating exercise-induced changes in gene expression to protein production and, ultimately, to clinical outcomes,” Dr Ligibel concluded.


  1. Ligibel JA, Irwin M, Dillon D. Impact of pre-operative exercise on breast cancer gene expression. Paper presented at: 39th San Antonio Breast Cancer Symposium; Dec 2016; San Antonio, TX.