Efrossini D Patsou, George T Alexias, Fotios G Anagnostopoulos, Michalis V Karamouzis

Breast cancer is one of the most common cancers affecting women worldwide and depression and anxiety are disturbing side effects of cancer diagnosis and treatment. The aim of this study was to examine the associations of physical activity in global health, quality of life (QoL), and psychological factors (depressive symptoms, self-esteem, and anxiety) in breast cancer survivors after completing cancer treatment and through survivorship. Demographic variables (marital status, education, income), medical status (cancer stage), and level of physical activity (metabolic equivalent of task [MET]) were tested as predictors of depressive mood, anxiety, self-esteem, and QoL in younger and older breast cancer survivors. One hundred and seventy-one Greek breast cancer survivors, who had completed cancer treatment at least one and a half years ago, were included in this study. Demographic and medical information, self-reported and objective physical activity levels, global health, QoL, depressive symptoms, self-esteem, and anxiety were assessed in all participants. Active women had lower depressive symptoms, less anxiety, higher self-esteem, and better global health and QoL, compared to the inactive ones, even in the long term after completing treatment through survivorship. Exercise had significant positive correlations with self-esteem, global health, and QoL (physical, role, emotional, cognitive, and social aspects). Moreover, significant negative correlations with anxiety and depressive symptoms were found. Multiple regression analysis revealed that MET and covariates such as income, education, and stage of cancer were significant predictors of depressive symptoms, self-esteem, anxiety, global health, and QoL in younger survivors, while MET, income, education, stage of cancer, and marital status were significant predictors of dependent variables for the older ones. It can be concluded that exercise should be recommended to cancer survivors even after treatment completion and through survivorship to achieve higher self-esteem, better QoL, and decreased anxiety and depressive symptoms.