Possible mechanisms mediating an association between physical activity and breast cancer.

The epidemiologic, methodologic, and biologic evidence that physical activity may be related inversely to breast cancer risk was the focus of a recent workshop. This article presents the workshop summary on biologic mechanisms that may mediate this association between physical activity and breast cancer. There is some evidence that physical activity may reduce breast cancer risk, although the exact biologic pathways have not been determined. Among the potential mechanisms discussed at the workshop were reductions in endogenous steroid exposure, alterations in menstrual cycle patterns, delay of age at menarche, increased energy expenditure and reduction in body weight, changes in insulin-like and other growth factors, and enhancement of natural immune mechanisms. Although physical activity may prove to be a modifiable risk factor for breast cancer, further mechanistically oriented research is necessary to both verify whether this is the case and to clarify the details of this association so that public health recommendations can be developed.