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Breast Cancer and Exercise

This national multi-center randomized controlled clinical trial (BREX, NCT00639210) explores the health benefits of exercise training among breast cancer survivors. 


Breast cancer is the most common cancer type among women with nearly 3,800 new women diagnosed in Finland every year. In addition to benefits, the adjuvant treatments of breast cancer can also lead to bone loss and reduced physical and mental performance. Exercise, in turn, has apparent potential to prevent these harmful consequences, but this has not yet been consistently shown among breast cancer survivors in an adequate-powered trial. 


The BREX trial aimed to investigate the effects of one-year intensive aerobic exercise on various health outcomes, including bone mineral density (BMD), physical performance, and quality of life (QoL).


Almost 500 breast cancer survivors aged 35 – 68 years were recruited in the BREX trial from three university hospitals (Helsinki, Tampere and Turku) and they were randomly assigned either into training or control group. The trial comprised one-year training randomized controlled intervention and follow-up assessments at 3, 5, and 10 years (completed in 2018). Feasibility of the planned training program, including jumping exercises and circuit training, was evaluated in a pilot study. The exercise group was asked to participate in supervised training once a week and do home training three times a week. 


On average, training including jumping was performed 2.2 times a week among premenopausal women and 2.7 times a week among postmenopausal women. One-year exercise training completely prevented femoral neck bone loss in premenopausal patients, whereas no treatment effect on BMD was seen in postmenopausal women. Neuromuscular performance improved among the trainees compared to controls. Cardiovascular fitness improved similarly in both groups and the increased physical activity accompanied improved QoL. Depression and fatigue were related to impaired QoL). 


Harri Sievänen, Research Director 


Five-year follow-up results of aerobic and impact training on bone mineral density in early breast cancer patients – PubMed ( 

Effectiveness of a 12-month Exercise Intervention on Physical Activity and Quality of Life of Breast Cancer Survivors; Five-year Results of the BREX-study – PubMed ( 

Saarto T, Penttinen HM, Sievänen H, Kellokumpu-Lehtinen PL, Hakamies-Blomqvist L, Nikander R, Huovinen R, Luoto R, Kautiainen H, Järvenpää S, Idman I, Utriainen M, Vehmanen L, Jääskeläinen AS, Elme A, Ruohola J, Palva T, Vertio H, Rautalahti M, Fogelholm M, Blomqvist C, Luoma ML. Effectiveness of a 12-month exercise program on physical performance and quality of life of breast cancer survivors. Anticancer Res. 2012;32:3875-84.

Nikander R, Sievänen H, Ojala K, Kellokumpu-Lehtinen PL, Palva T, Blomqvist C, Luoto R, Saarto T. Effect of exercise on bone structural traits, physical performance and body composition in breast cancer patients–a 12-month RCT. J Musculoskelet Neuronal Interact. 2012;12:127-35.

Saarto T, Sievänen H, Kellokumpu-Lehtinen P, Nikander R, Vehmanen L, Huovinen R, Kautiainen H, Järvenpää S, Penttinen HM, Utriainen M, Jääskeläinen AS, Elme A, Ruohola J, Palva T, Vertio H, Rautalahti M, Fogelholm M, Luoto R, Blomqvist C. Effect of supervised and home exercise training on bone mineral density among breast cancer patients. A 12-month randomised controlled trial. Osteoporos Int. 2012 May;23(5):1601-12.

Penttinen HM, Saarto T, Kellokumpu-Lehtinen P, Blomqvist C, Huovinen R, Kautiainen H, Järvenpää S, Nikander R, Idman I, Luoto R, Sievänen H, Utriainen M, Vehmanen L, Jääskeläinen AS, Elme A, Ruohola J, Luoma M, Hakamies-Blomqvist L. Quality of life and physical performance and activity of breast cancer patients after adjuvant treatments. Psychooncology. 2011;20:1211-20.

Nikander R, Sievänen H, Ojala K, Oivanen T, Kellokumpu-Lehtinen PL, Saarto T. Effect of a vigorous aerobic regimen on physical performance in breast cancer patients – a randomized controlled pilot trial. Acta Oncol. 2007;46(2):181-6. 

Last updated: 21.9.2023

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