Effects of physical activity on psychological well-being outcomes in breast cancer survivors from prediagnosis to posttreatment survivorship

Objective: The purpose of this study was to examine the effects of physical activity from prediagnosis to posttreatment survivorship on the psychological well-being (PWB) outcomes of fatigue, depression, anxiety, and quality of life (QoL) in breast cancer survivors (BCS). Methods: Participants (N = 387) completed a questionnaire battery by using an iPad-based platform. Measures included self-reported PA (before diagnosis and currently) and perceptions of fatigue, depression, anxiety, and QoL. Multivariate analysis of covariance was used to examine differences in PWB among BCS categorized into 1 of 4 physical activity levels: (a) low-active prediagnosis, low-active currently (low-active maintainers; n = 128); (b) low-active prediagnosis, active currently (increasers; n = 74); (c) active prediagnosis, low-active currently (decreasers; n = 52); and (d) active prediagnosis, active currently (high-active maintainers; n = 136). Participants were classified as active (≥24 units) or low-active (<24 units) by using Godin Leisure-Time Exercise Questionnaire cut-points for health benefits. Results: Fatigue and depression were lowest, and QoL was highest among women in the high-active maintainers category, followed by the increasers, low-active maintainers, and decreasers. No differences in anxiety were observed across categories. Women in the high-active maintainers category differed significantly in fatigue, depression, and QoL from both low-active categories (low-active maintainers and decreasers), P ≤.001. Women in the increasers category also differed significantly in fatigue, depression, and QoL from the decreasers, P ≤.01. Conclusion: Low physical activity during survivorship was associated with greater fatigue and depression and lower QoL. Implications for cancer survivors: Efforts to help increase or maintain high levels of physical activity may be critical to helping BCS maintain their PWB.