Physiological Mechanisms of Exercise Related to Prevention and Treatment of Breast Cancer: A review Exercise for prevention and treatment of BC
Abstract
Background: Considering limitations related to intensity, duration, and mode of exercise and possible physiological mechanisms, this study aimed to summarize the physiological mechanisms emphasizing inflammation, angiogenesis, and immunology of different exercises related to prevention and treatment of breast cancer.
Methods: In the current review study, different platforms were analyzed including PubMed, Scopus, Cochrane, Embase, Web of Science, Science Direct, Google Scholar, and Research Gate as well as Iranian databases such as Scientific Information Database (SID) and Magiran. The data was reviewed until May 2024. Search keywords included “exercise", "sport”, “physical exercise”, “intensity, training”, “breast cancer”, “inflammation”, “angiogenesis”,” immunology”, and “physiological mechanisms”.
Results: Among several proposed mechanisms, inflammation, immunity and angiogenesis have been mentioned as important indices but there are ambiguities regarding the influence of different intensities and durations of exercise on breast cancer prevention and treatment. Other effective factors such as the effect of exercise on gene regulation and some other mechanisms have been proposed as possible mediators.
Conclusion: According to some previous studies, aerobic exercise induces positive effects on preventing and treating breast cancer through reducing inflammation, improving angiogenesis, and enhancing immunological mechanisms. Regarding duration and intensity, long term regular exercise (>8 weeks), in the form of aerobic and especially high intensity interval training (HIIT) reduces inflammation. while the effect of short-term exercise training is not clear yet and high intensity exercise may induce suppressing effects on the immune system. Therefore, the effect of intensity and duration of exercise on physiological mechanisms must be clarified.
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References
Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524-541. doi: 10.3322/caac.21754.
Haghpanah S, Hosseini-Bensenjan M, Ramzi M, Khosravizadegan Z, Rezaianzadeh A. Investigating the trends of incidence rates of breast cancer in Southern Iran: a population based survey. BMC Women's Health. 2023;23(1):589. doi: 10.1186/s12905-023-02757-7.
Cortes HNP-LF. J. Gnant M. Houssami N. Poortmans P. Ruddy K. Tsang J. Cardoso F. Breast Cancer. Nat Rev Dis Primers. 2019;5:66. doi: 10.1038/s41572-019-0111-2.
López-Cortés A, Cabrera-Andrade A, Vázquez-Naya JM, et al. Prediction of breast cancer proteins using molecular descriptors and artificial neural networks: a focus on cancer immunotherapy proteins, metastasis driver proteins, and RNA-binding proteins.Sci Rep. 2019:840108. doi: 10.1038/s41598-020-65584-y.
DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019. CA Cancer J Clin. 2019;69(6):438-451.
Quang DT, Thi TL, Di KN, Quynh CVT, Hoa HNT, Ngoc QP. Illuminating the breast cancer survival rates among Southeast Asian women: A systematic review and meta-analysis spanning four decades. Curr Probl Cancer. 2024;48:101062. doi: 10.1016/j.currproblcancer.2024.101062.
Carayol M, Ninot G, Senesse P, et al. Short-and long-term impact of adapted physical activity and diet counseling during adjuvant breast cancer therapy: the “APAD1” randomized controlled trial. BMC cancer. 2019;19(1):1-20. doi: 10.1186/s12885-019-5896-6.
Sun Y-S, Zhao Z, Yang Z-N, et al. Risk factors and preventions of breast cancer. Medicine (Baltimore). 2017;13(11):1387. doi: 10.1097/MD.0000000000036905.
Wild C, Weiderpass E, Stewart BW. World cancer report: cancer research for cancer prevention. IARC Press; 2020.
Eliassen AH, Hankinson SE, Rosner B, Holmes MD, Willett WC. Physical activity and risk of breast cancer among postmenopausal women. Arch Intern Med. 2010;170(19):1758-1764. doi: 10.1001/archinternmed.2010.363.
Buffart LM, Sweegers MG, May AM, et al. Targeting exercise interventions to patients with cancer in need: an individual patient data meta-analysis. J Natl Cancer Inst. 2018;110(11):1190-1200. doi: 10.1093/jnci/djy161.
Campbell KL, Winters-Stone K, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51(11):2375. doi: 10.1249/MSS.0000000000002116.
Aydin M, Kose E, Odabas I, Bingul BM, Demirci D, Aydin Z. The effect of exercise on life quality and depression levels of breast cancer patients. Asian Pac J Cancer Prev. 2021;22(3):725. doi: 10.31557/APJCP.2021.22.3.725.
Chen X, Shi X, Yu Z, Ma X. High‐intensity interval training in breast cancer patients: A systematic review and meta‐analysis. Cancer Med. 2023;12(17):17692-17705. doi: 10.1002/cam4.6387. Epub 2023 Aug 17.
Aguilar-Cazares D, Chavez-Dominguez R, Carlos-Reyes A, Lopez-Camarillo C, Hernadez de la Cruz ON, Lopez-Gonzalez JS. Contribution of angiogenesis to inflammation and cancer. Front Oncol. 2019;9:1399. doi: 10.3389/fonc.2019.01399.
Philippou A, Tryfonos A, Theos A, et al. Expression of tissue remodelling, inflammation-and angiogenesis-related factors after eccentric exercise in humans. Mol Biol Rep. 2021;48(5):4047-4054. doi: 10.1007/s11033-021-06412-y.
Jones SB, Thomas GA, Hesselsweet SD, Alvarez-Reeves M, Yu H, Irwin ML. Effect of exercise on markers of inflammation in breast cancer survivors: the Yale exercise and survivorship study. Cancer Prev Res (Phila). 2013;6(2):109-118. doi: 10.1158/1940-6207.CAPR-12-0278.
Brenner DR, Ruan Y, Adams SC, Courneya KS, Friedenreich CM. The impact of exercise on growth factors (VEGF and FGF2): results from a 12-month randomized intervention trial. Eur Rev Aging Phys Act. 2019;16(1):1-6. doi: 10.1186/s11556-019-0215-4
Haley JS, Hibler EA, Zhou S, Schmitz KH, Sturgeon KM. Dose‐dependent effect of aerobic exercise on inflammatory biomarkers in a randomized controlled trial of women at high risk of breast cancer. Cancer. 2020;126(2):329-336. doi: 10.1002/cncr.32530.
Schauer T, Mazzoni A-S, Henriksson A, et al. Exercise intensity and markers of inflammation during and after (neo-) adjuvant cancer treatment. Endocr Relat Cancer. 2021;28(3):191-201. doi: 10.1530/ERC-20-0507.
van Vulpen JK, Schmidt ME, Velthuis MJ, et al. Effects of physical exercise on markers of inflammation in breast cancer patients during adjuvant chemotherapy. Breast Cancer Res Treat. 2018;168:421-431. doi: 10.1007/s10549-017-4608-7.
Guinan E, Hussey J, Broderick J, et al. The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors—a pilot study. Support Care Cancer. 2013;21:1983-1992. doi: 10.1007/s00520-013-1743-5.
Dieli-Conwright CM, Parmentier J-H, Sami N, et al. Adipose tissue inflammation in breast cancer survivors: effects of a 16-week combined aerobic and resistance exercise training intervention. Breast Cancer Res Treat. 2018;168:147-157. doi: 10.1007/s10549-017-4576-y.
de Jesus Leite MAF, Mariano IM, Dechichi JGC, Giolo JS, de Carvalho Gonçalves Á, Puga GM. Exercise training and detraining effects on body composition, muscle strength and lipid, inflammatory and oxidative markers in breast cancer survivors under tamoxifen treatment. Life Sci. 2021;284:119924. doi: 10.1016/j.lfs.2021.119924.
Rogers LQ, Fogleman A, Trammell R, et al. Effects of a physical activity behavior change intervention on inflammation and related health outcomes in breast cancer survivors: pilot randomized trial. Integr Cancer Ther. 2013;12(4):323-335. doi: 10.1177/1534735412449687.
Niemiro GM, Coletta AM, Agha NH, et al. Salutary effects of moderate but not high intensity aerobic exercise training on the frequency of peripheral T-cells associated with immunosenescence in older women at high risk of breast cancer: a randomized controlled trial. Immun Ageing. 2022;19(1):17. doi: 10.1186/s12979-022-00266-z.
Arana Echarri A, Struszczak L, Beresford M, Campbell JP, Thompson D, Turner JE. The effects of exercise training for eight weeks on immune cell characteristics among breast cancer survivors. Front Sports Act Living. 2023;5:1163182. doi: 10.3389/fspor.2023.1163182
Coletta AM, Agha NH, Baker FL, et al. The impact of high-intensity interval exercise training on NK-cell function and circulating myokines for breast cancer prevention among women at high risk for breast cancer. Breast Cancer Res Treat. 2021;187(2):407-416. doi: 10.1007/s10549-021-06111-z.
Cannioto RA, Hutson A, Dighe S, et al. Physical activity before, during, and after chemotherapy for high-risk breast cancer: relationships with survival. J Natl Cancer Inst. 2021;113(1):54-63. doi: 10.1093/jnci/djaa046.
Soleimani R, Koushkie Jahromi M, Mahmoodi A, Nemati J. The Effect of Eight Weeks Pilatese Training on Some of White Blood Cells in Breast Cancer Patients. Iranian Journal of Breast Diseases. 2022;15(1):18-32.doi: 10.30699/ijbd.15.1.18.
Koivula T, Lempiäinen S, Rinne P, et al. The effect of acute exercise on circulating immune cells in newly diagnosed breast cancer patients. Sci Rep. 2023;13(1):6561. doi: 10.1038/s41598-023-33432-4.
Khosravi N, Hanson ED, Farajivafa V, et al. Exercise-induced modulation of monocytes in breast cancer survivors. Brain Behav Immun Health. 2021;14:100216. doi: 10.1016/j.bbih.2021.100216
Lee K-J, An K-O. Impact of High-Intensity Circuit Resistance Exercise on Physical Fitness, Inflammation, and Immune Cells in Female Breast Cancer Survivors: A Randomized Control Trial. Int J Environ Res Public Health. 2022;19(9):5463. doi: 10.3390/ijerph19095463.
Isanejad A, Nazari S, Gharib B, Motlagh AG. 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. J Sport Health Sci. 2023;12(6):674-689. doi: 10.1016/j.jshs.2023.07.001
Yeo N, Woo J, Shin K, Park J, Kang S. The effects of different exercise intensity on myokine and angiogenesis factors. J Sports Med Phys Fitness. 2012;52(4):448-454. PMID: 22828466
Hooshmand Moghadam B, Golestani F, Bagheri R, et al. The effects of high-intensity interval training vs. moderate-intensity continuous training on inflammatory markers, body composition, and physical fitness in overweight/obese survivors of breast cancer: a randomized controlled clinical trial. Cancers (Basel). 2021;13(17):4386. doi: 10.3390/cancers13174386.
Rafiei MM, Soltani R, Kordi MR, Nouri R, Gaeini AA. Gene expression of angiogenesis and apoptotic factors in female BALB/c mice with breast cancer after eight weeks of aerobic training. Iran J Basic Med Sci. 2021;24(9):1196. doi: 10.22038/ijbms.2021.55582.12427.
Jones LW, Viglianti BL, Tashjian JA, et al. Effect of aerobic exercise on tumor physiology in an animal model of human breast cancer. J Appl Physiol (1985). 2010;108(2):343-348. doi: 10.1152/japplphysiol.00424.2009
Rocha AF, Silva A, Gabriel J, et al. Long-term exercise training as a modulator of mammary cancer vascularization. Biomed Pharmacother. 2016 Jul:81:273-280. doi: 10.1016/j.biopha.2016.04.030.
Betof AS, Lascola CD, Weitzel D, et al. Modulation of murine breast tumor vascularity, hypoxia, and chemotherapeutic response by exercise. J Natl Cancer Inst. 2015;107(5). doi: 10.1093/jnci/djv040.
Bangsub L, Chung W. Effects of aerobic exercise on cytokine expression in a breast cancer mouse model. Iran J Public Health. 2020;49(1):14. PMID: 32309219
Ahmadi A, Sheikholeslami-Vatani D, Ghaeeni S, Baazm M. The effects of different training modalities on monocarboxylate transporters MCT1 and MCT4, hypoxia inducible factor-1α (HIF-1α), and PGC-1α gene expression in rat skeletal muscles. Mol Biol Rep. 2021;48:2153-2161. doi: 10.1007/s11033-021-06224-0.
Shahabpour E, Koushkie Jahromi M, Salasi M, Tamadon GH. Effect of endurance training on vascular endothelial growth factor and vascular endothelial growth factor receptor 2 in tumor of breast cancer bearing mice. Gorgan Univ Med Sci. 2018;20(3):11-18.
Shalamzari SA, Agha-Alinejad H, Alizadeh S, et al. The effect of exercise training on the level of tissue IL-6 and vascular endothelial growth factor in breast cancer bearing mice. Iran J Basic Med Sci. 2014;17(4):231. PMID: 24904714
Salehpoor Z, Jahromi BN, Tanideh N, Nemati J, Akbarzade-Jahromi M, Jahromi MK. High intensity interval training is superior to moderate intensity continuous training in enhancing the anti-inflammatory and apoptotic effect of pentoxifylline in the rat model of endometriosis. J Reprod Immunol. 2023;156:103832. doi: 10.1016/j.jri.2023.103832.
Baniyash M, Sade-Feldman M, Kanterman J. Chronic inflammation and cancer: suppressing the suppressors. Cancer Immunol Immunother. 2014;63(1):11-20. doi: 10.1007/s00262-013-1468-9.
Singh N, Baby D, Rajguru JP, Patil PB, Thakkannavar SS, Pujari VB. Inflammation and cancer. Ann Afr Med. 2019;18(3):121. doi: 10.4103/aam.aam_56_18
Beavers KM, Brinkley TE, Nicklas BJ. Effect of exercise training on chronic inflammation. Clin Chim Acta. 2010;411(11-12):785-793. doi: 10.1016/j.cca.2010.02.069
Nicklas BJ, Brinkley TE. Exercise training as a treatment for chronic inflammation in the elderly. Exerc Sport Sci Rev. 2009;37(4):165. doi: 10.1097/JES.0b013e3181b7b3d9.
Ramos JS, Dalleck LC, Tjonna AE, Beetham KS, Coombes JS. The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis. Sports Med. 2015;45:679-692. doi: 10.1007/s40279-015-0321-z.
Guo Z, Li M, Cai J, Gong W, Liu Y, Liu Z. Effect of high-intensity interval training vs. moderate-intensity continuous training on fat loss and cardiorespiratory fitness in the young and middle-aged a systematic review and meta-analysis. Int J Environ Res Public Health. 2023;20(6):4741. doi: 10.3390/ijerph20064741
Wang Y, Wang S, Meng X, Zhou H. Effect of high-intensity interval training and moderate-intensity continuous training on cardiovascular risk factors in adolescents: Systematic review and meta-analysis of randomized controlled trials. Physiol Behav. 2024:114459. doi: 10.1016/j.physbeh.2024.114459.
Khanna D, Khanna S, Khanna P, Kahar P, Patel BM. Obesity: a chronic low-grade inflammation and its markers. Cureus. 2022;14(2). doi: 10.7759/cureus.22711.
Cerqueira É, Marinho DA, Neiva HP, Lourenço O. Inflammatory effects of high and moderate intensity exercise—a systematic review. Front Physiol. 2020;10:489354. doi: 10.3389/fphys.2019.01550.
Suman S, Sharma PK, Rai G, et al. Current perspectives of molecular pathways involved in chronic inflammation-mediated breast cancer. Biochem Biophys Res Commun. 2016;472(3):401-409. doi: 10.1016/j.bbrc.2015.10.133.
Fouad TM, Kogawa T, Reuben JM, Ueno NT. The role of inflammation in inflammatory breast cancer. Adv Exp Med Biol. 2014:53-73. doi: 10.1007/978-3-0348-0837-8_3.
Bhatelia K, Singh K, Singh R. TLRs: linking inflammation and breast cancer. Cell Signal. 2014;26(11):2350-2357. doi: 10.1016/j.cellsig.2014.07.035.
Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11(9):607-615. doi: 10.1038/nri3041.
Collao N, Rada I, Francaux M, Deldicque L, Zbinden-Foncea H. Anti-Inflammatory Effect of Exercise Mediated by Toll-Like Receptor Regulation in Innate Immune Cells–A Review: Anti-inflammatory effect of exercise mediated by Toll-like receptor regulation in innate immune cells. Int Rev Immunol. 2020;39(2):39-52. doi: 10.1080/08830185.2019.1682569.
Kerbel R, Folkman J. Clinical translation of angiogenesis inhibitors. Nat Rev Cancer. 2002;2(10):727-739. doi: 10.1038/nrc905.
Rankin EB, Giaccia AJ. Hypoxic control of metastasis. Science. 2016;352(6282):175-180. doi: 10.1126/science.aaf4405
Madu CO, Wang S, Madu CO, Lu Y. Angiogenesis in breast cancer progression, diagnosis, and treatment. J Cancer. 2020;11(15):4474. doi: 10.7150/jca.44313
Ayoub NM, Jaradat SK, Al-Shami KM, Alkhalifa AE. Targeting Angiogenesis in Breast Cancer: Current Evidence and Future Perspectives of Novel Anti-Angiogenic Approaches. Front Pharmacol. 2022;13. doi: 10.3389/fphar.2022.838133.
de Heer EC, Jalving M, Harris AL. HIFs, angiogenesis, and metabolism: elusive enemies in breast cancer. J Clin Invest. 2020;130(10):5074-5087. doi: 10.1172/JCI137552.
Faustino-Rocha A, Silva A, Gabriel J, et al. Long-term exercise training as a modulator of mammary cancer vascularization. Biomed Pharmacother. 2016;81:273-280. doi: 10.1016/j.biopha.2016.04.030.
Pedersen L, Christensen JF, Hojman P. Effects of exercise on tumor physiology and metabolism. Cancer J. 2015;21(2):111-116. doi: 10.1097/PPO.0000000000000096.
Yazdani F, Shahidi F, Karimi P. The effect of 8 weeks of high-intensity interval training and moderate-intensity continuous training on cardiac angiogenesis factor in diabetic male rats. J Physiol Biochem. 2020;76:291-299. doi: 10.1007/s13105-020-00733-5.
Jones LW, Fels DR, West M, et al. Modulation of Circulating Angiogenic Factors and Tumor Biology by Aerobic Training in Breast Cancer Patients Receiving Neoadjuvant ChemotherapyAngiogenic Factors and Aerobic Training in Breast Cancer. Cancer Prev Res (Phila). 2013;6(9):925-937. doi: 10.1158/1940-6207.CAPR-12-0416.
Kopp R, Köblitz L, Egg M, Pelster B. HIF signaling and overall gene expression changes during hypoxia and prolonged exercise differ considerably. Physiol Genomics. 2011;43(9):506-516. doi: 10.1152/physiolgenomics.00250.2010.
Di Meo S, Napolitano G, Venditti P. Mediators of physical activity protection against ROS-linked skeletal muscle damage. Int J Mol Sci. 2019;20(12):3024. doi: 10.3390/ijms20123024
Krüger K, Lechtermann A, Fobker M, Völker K, Mooren F. Exercise-induced redistribution of T lymphocytes is regulated by adrenergic mechanisms. Brain Behav Immun. 2008;22(3):324-338. doi: 10.1016/j.bbi.2007.08.008.
Idorn M, Hojman P. Exercise-dependent regulation of NK cells in cancer protection. Trends Mol Med. 2016;22(7):565-577. doi: 10.1016/j.molmed.2016.05.007.
Schmidt T, Van Mackelenbergh M, Wesch D, Mundhenke C. Physical activity influences the immune system of breast cancer patients. J Cancer Res Ther. 2017;13(3):392. doi: 10.4103/0973-1482.150356.
Hapuarachi B, Danson S, Wadsley J, Muthana M. Exercise to transform tumours from cold to hot and improve immunotherapy responsiveness. Front Immunol. 2023;14:1335256. doi: 10.3389/fimmu.2023.1335256.
Lavín-Pérez AM, Collado-Mateo D, Abbasi S, Ferreira-Júnior JB, Hekmatikar AHA. Effects of exercise on immune cells with tumor-specific activity in breast cancer patients and survivors: a systematic review and meta-analysis. Support Care Cancer. 2023;31(9):507. doi: 10.1007/s00520-023-07968-0.
Coletta AM, Agha NH, Baker FL, et al. The impact of high-intensity interval exercise training on NK-cell function and circulating myokines for breast cancer prevention among women at high risk for breast cancer. Breast Cancer Res Treat. 2021;187:407-416. doi: 10.1007/s10549-021-06111-z.
Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. cell. 2011;144(5):646-674. doi: 10.1016/j.cell.2011.02.013.
Uhlemann M, Möbius-Winkler S, Fikenzer S, et al. Circulating microRNA-126 increases after different forms of endurance exercise in healthy adults. Eur J Prev Cardiol. 2014;21(4):484-491. doi: 10.1177/2047487312467902.
Zhang FF, Cardarelli R, Carroll J, et al. Physical activity and global genomic DNA methylation in a cancer-free population. Epigenetics. 2011;6(3):293-299. doi: 10.4161/epi.6.3.14378.
White AJ, Sandler DP, Bolick SC, Xu Z, Taylor JA, DeRoo LA. Recreational and household physical activity at different time points and DNA global methylation. Eur J Cancer. 2013;49(9):2199-2206. doi: 10.1016/j.ejca.2013.02.013.
Gillman AS, Helmuth T, Koljack CE, Hutchison KE, Kohrt WM, Bryan AD. The effects of exercise duration and intensity on breast cancer-related dna methylation: A randomized controlled trial. Cancers (Basel). 2021;13(16):4128. doi: 10.3390/cancers13164128.
Boyne DJ, King WD, Brenner DR, McIntyre JB, Courneya KS, Friedenreich CM. Aerobic exercise and DNA methylation in postmenopausal women: An ancillary analysis of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. PLoS One. 2018;13(6):e0198641. doi: 10.1371/journal.pone.0198641.
Chauhan N, Dhasmana A, Jaggi M, Chauhan SC, Yallapu MM. miR-205: A Potential Biomedicine for Cancer Therapy. Cells. 2020 ;9(9):1957. doi: 10.3390/cells9091957.
Dufresne S, Rébillard A, Muti P, Friedenreich CM, Brenner DR. A review of physical activity and circulating miRNA expression: implications in cancer risk and progression. Cancer Epidemiol Biomarkers Prev. 2018;27(1):11-24. doi: 10.1158/1055-9965.EPI-16-0969.
Whitham M, Febbraio MA. The ever-expanding myokinome: discovery challenges and therapeutic implications. Nat Rev Drug Discov. 2016;15(10):719-729. doi: 10.1038/nrd.2016.153.
Gannon NP, Vaughan RA, Garcia‐Smith R, Bisoffi M, Trujillo KA. Effects of the exercise‐inducible myokine irisin on malignant and non‐malignant breast epithelial cell behavior in vitro. Int J Cancer. 2015;136(4):E197-E202. doi: 10.1002/ijc.29142.
Aoi W, Naito Y, Takagi T, et al. A novel myokine, secreted protein acidic and rich in cysteine (SPARC), suppresses colon tumorigenesis via regular exercise. Gut. 2013;62(6):882-889. doi: 10.1136/gutjnl-2011-300776.
Roy P, Chowdhury S, Roy HK. Exercise-induced myokines as emerging therapeutic agents in colorectal cancer prevention and treatment. In. Vol 14: Future Oncol. 2018:309-312. doi: 10.2217/fon-2017-0555.
Wang P-y, Zhuang J, Hwang PM. p53: exercise capacity and metabolism. Curr Opin Oncol. 2012;24(1):76. doi: 10.1097/CCO.0b013e32834de1d8
Wang M, Yu B, Westerlind K, et al. Prepubertal physical activity up-regulates estrogen receptor β, BRCA1 and p53 mRNA expression in the rat mammary gland. Breast Cancer Res Treat. 2009;115(1):213-220. doi: 10.1007/s10549-008-0062-x.
Herranz‐Gómez A, Cuenca‐Martínez F, Suso‐Martí L, et al. Effectiveness of HIIT in patients with cancer or cancer survivors: An umbrella and mapping review with meta‐meta‐analysis. Scand J Med Sci Sports. 2022;32(11):1522-1549. doi: 10.1111/sms.14223.
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