Alberta Physical Activity and Breast Cancer (ALPHA)

Summary of the ALPHA Trial

The Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial was designed to determine the effects of a one year supervised exercise intervention on biologic markers hypothesized to mediate the inverse association between physical activity and breast cancer risk. The trial was led by my colleague Dr. Christine Friedenreich of the Alberta Health Services and was the largest to date (n=320). In the primary paper, we found that the aerobic exercise intervention resulted in significant changes in estradiol and sex hormone binding globulin that were consistent with a lower risk of postmenopausal breast cancer [Friedenreich et al. J. Clin. Onc. 2010; 28 :1458-66] . We also found c hanges in adiposity [Friedenreich et al. Int. J. Obesity 2011; 35 :427-435 ] as well as insulin and leptin [Friedenreich et al. Endocr Relat Cancer in press ] that are associated with lower breast cancer risk. Finally, we found that the exercise group experienced significantly better quality of life in terms of their physical functioning, general health, vitality, and bodily pain [ Courneya et al. Prev. Med. 2011; 52 :26-32] . We concluded from the ALPHA trial that there is good biological data supporting a causal effect of exercise on breast cancer risk. Moreover, exercise may be a particularly attractive option for breast cancer prevention because it also improves quality of life, unlike drug or dietary interventions that typically have no effect or even a negative effect on quality of life .

Publications from the ALPHA Trial

Friedenreich, C.M., Woolcott, C.G., McTiernan, A., Ballard-Barbash, R., Brant, R.F., Stancyzk, F.Z., Terry, T., Boyd, N.F., Yaffe, M.J., Irwin, M.L., Jones, C.A., Yasui, Y., Campbell, K.L. , McNeely, M.L. , Karvinen, K.H. , Wang, Q., & Courneya, K.S. (2010). Alberta Physical Activity and Breast Cancer Prevention trial: Sex hormone changes in a year-long exercise intervention among postmenopausal women. Journal of Clinical Oncology , 28 , 1458-1466.

Woolcott, C.G., Courneya, K.S. , Boyd, N.F., Yaffe, M.J., Terry, T., McTiernan, A., Brant, R., Ballard-Barbash, R., Irwin, M.L., Jones, C.A., Brar, S., Campbell, K.L. , McNeely, M.L. , Karvinen, K.H. , & Friedenreich, C.M. (2010). Mammographic density change with 1 year of aerobic exercise among postmenopausal women: A randomized controlled trial. Cancer Epidemiology, Biomarkers & Prevention , 19 , 1112-1121.

Friedenreich, C.M., Woolcott, C.G., McTiernan, A., Terry, T., Brant, R., Ballard-Barbash, R., Irwin, M.L., Jones, C.A., Boyd, N.F., Yaffe, M.J., Campbell, K.L. , McNeely, M.L. , Karvinen, K.H. , & Courneya, K.S. (2011). Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: A randomized controlled trial. International Journal of Obesity , 35 , 427-435.

Friedenreich, C.M., Neilson, H.K., Woolcott, C.G., McTiernan, A., Wang, Q., Ballard-Barbash, R., Jones, C.A., Stanczyk, F.Z., Brant, R.F., Yasui, Y., Irwin, M.L., Campbell, K.L. , McNeely, M.L. , Karvinen, K.H. , & Courneya, K.S. (2011). Changes in insulin resistance indicators, IGFs, and adipokines in a year-long trial of aerobic exercise in postmenopausal women. Endocrine-Related Cancer , 18 , 357-369.

Courneya, K.S. , Tamburrini, A.L., Woolcott, C.G., McNeely, M.L. , Karvinen, K.H. , Campbell, K.L. , McTiernan, A., & Friedenreich, C.M. (2011). The Alberta physical activity and breast cancer prevention trial: Quality of life outcomes. Preventive Medicine , 52 , 26-32.

Friedenreich, C.M., Neilson, H.K., Woolcott, C.G., Wang, Q., Yasui, Y., Brant, R.F., Stanczyk, F.Z., Campbell, K.L. , & Courneya, K.S. (in press). Mediators and moderators of the effects of a year-long exercise intervention on endogenous sex hormones in postmenopausal women. Cancer Causes and Control .

Courneya, K.S. , Karvinen, K.H. , McNeely, M.L. , Campbell, K.L. , Brar, S., Woolcott, C.G., McTiernan, A., Ballard-Barbash, R., & Friedenreich, C.M. (in press). Predictors of adherence to supervised and unsupervised exercise in the Alberta Physical Activity and Breast Cancer Prevention Trial. Journal of Physical Activity and Health .

Friedenreich, C.M., Neilson, H.K., Woolcott, C.G., Wang, Q., Stanczyk, F.Z., McTiernan, A., Jones, C.A., Irwin, M.L., Yasui, Y., & Courneya, K.S. (2011). Alberta physical activity and breast cancer prevention trial: Inflammatory marker changes in a year-long exercise intervention among postmenopausal women. Manuscript submitted for publication.