Physical activity, breast cancer, risk, systematic review, meta-analysis
Introduction: Breast cancer is one of the main causes of death worldwide. Many epidemiologic studies suggest that physical activity is associated with reduced breast cancer risk despite this has not been a systematic conclusions. Objective: The aim of this systematic review was to evaluate the effect of physical activity on breast cancer prevention. Materials and methods: Articles were analyzed on Electronic databases (Pubmed, Embase, Scielo, Cochrane, Cancerlit e Google Scholar) and Manual searches were also conducted through gynecology or physical education journals and the bibliographies of reviewed articles for case control and cohort studies. Selected studies were assessed by two independent investigators for methodological quality, using the NewCastle scale. The fully adjusted risk estimates and 95% confidence intervals for the highest versus lowest level of activity were documented for each study as well as evidence for a dose–response relationship. Methodologic quality was also assessed. Due to statistical and methodologic heterogeneity among studies, we did not carry out statistical pooling. To draw conclusions, we performed a best-evidence synthesis taking study quality into account. Nine cohort studies and 11 case– control studies were evaluated. There was varable evidence for an inverse association between physical activity and breast cancer with risk reductions ranging from 13% to 71% for cohort studies 3 to 76 % for case control studies Due to statistical and methodologic heterogeneity among studies, we did not carry out statistical pooling. Conclusion: there is evidence for an inverse association between physical activity and breast cancer risk. Observational studies suggest a protective effect of breast cancer when performed moderate to vigorous physical activity, but there is a great limitation in the measurement of physical activity variable. Studies with higher levels of evidence are needed to confirm these results.