Physical Activity and Survival in Postmenopausal Women with Breast Cancer: Results from the Women's Health Initiative

被引:228
作者
Irwin, Melinda L. [1 ]
McTiernan, Anne [2 ]
Manson, JoAnn E. [3 ,4 ]
Thomson, Cynthia A. [5 ]
Sternfeld, Barbara [6 ]
Stefanick, Marcia L. [7 ]
Wactawski-Wende, Jean [8 ]
Craft, Lynette [9 ]
Lane, Dorothy [10 ]
Martin, Lisa W. [11 ]
Chlebowski, Rowan [12 ]
机构
[1] Yale Univ, Sch Publ Hlth, Div Chron Dis Epidemiol, New Haven, CT 06520 USA
[2] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[3] Brigham & Womens Hosp, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Boston, MA USA
[5] Univ Arizona, Arizona Canc Ctr, Tucson, AZ USA
[6] Kaiser Permanente, Oakland, CA USA
[7] Stanford Univ, Sch Med, Prevent Res Ctr, Stanford, CA 94305 USA
[8] SUNY Buffalo, Dept Social & Prevent Med, Buffalo, NY 14260 USA
[9] Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA
[10] SUNY Stony Brook, Sch Med, Stony Brook, NY 11794 USA
[11] George Washington Univ, Washington, DC USA
[12] Harbor UCLA Med Ctr, Los Angeles Biomed Res Inst, Torrance, CA 90509 USA
基金
美国国家卫生研究院;
关键词
RANDOMIZED CONTROLLED-TRIAL; CLINICAL-TRIAL; GROWTH-FACTORS; DIAGNOSIS; MORTALITY; EXERCISE; RISK; QUESTIONNAIRE; OBESITY; INSULIN;
D O I
10.1158/1940-6207.CAPR-10-0295
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Although studies have shown that physically active breast cancer survivors have lower all-cause mortality, the association between change in physical activity from before to after diagnosis and mortality is not clear. We examined associations among pre- and postdiagnosis physical activity, change in pre- to postdiagnosis physical activity, and all-cause and breast cancer-specific mortality in postmenopausal women. A longitudinal study of 4,643 women diagnosed with invasive breast cancer after entry into the Women's Health Initiative study of postmenopausal women. Physical activity from recreation and walking was determined at baseline (prediagnosis) and after diagnosis (assessed at the 3 or 6 years post-baseline visit). Women participating in 9 MET-h/wk or more (similar to 3 h/wk of fast walking) of physical activity before diagnosis had a lower all-cause mortality (HR = 0.61; 95% CI, 0.44-0.87; P = 0.01) compared with inactive women in multivariable adjusted analyses. Women participating in >= 9 or more MET-h/wk of physical activity after diagnosis had lower breast cancer mortality (HR 0.61; 95% CI, 0.35-0.99; P = 0.049) and lower all-cause mortality (HR = 0.54; 95% CI, 0.38-0.79; P < 0.01). Women who increased or maintained physical activity of 9 or more MET-h/wk after diagnosis had lower all-cause mortality (HR = 0.67; 95% CI, 0.46-0.96) even if they were inactive before diagnosis. High levels of physical activity may improve survival in postmenopausal women with breast cancer, even among those reporting low physical activity prior to diagnosis. Women diagnosed with breast cancer should be encouraged to initiate and maintain a program of physical activity. Cancer Prev Res; 4(4); 522-9. (C) 2011 AACR.
引用
收藏
页码:522 / 529
页数:8
相关论文
共 19 条
[1]   COMPENDIUM OF PHYSICAL ACTIVITIES - CLASSIFICATION OF ENERGY COSTS OF HUMAN PHYSICAL ACTIVITIES [J].
AINSWORTH, BE ;
HASKELL, WL ;
LEON, AS ;
JACOBS, DR ;
MONTOYE, HJ ;
SALLIS, JF ;
PAFFENBARGER, RS .
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 1993, 25 (01) :71-80
[2]  
[Anonymous], DIS BREAST
[3]  
[Anonymous], CONTROL CLIN TRIALS
[4]   Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: A multicenter randomized controlled trial [J].
Courneya, Kerry S. ;
Segal, Roanne J. ;
Mackey, John R. ;
Gelmon, Karen ;
Reid, Robert D. ;
Friedenreich, Christine M. ;
Ladha, Aliya B. ;
Proulx, Caroline ;
Vallance, Jeffrey K. H. ;
Lane, Kirstin ;
Yasui, Yutaka ;
McKenzie, Donald C. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (28) :4396-4404
[5]   Physical activity and survival after diagnosis of invasive breast cancer [J].
Holick, Crystal N. ;
Newcomb, Polly A. ;
Trentham-Dietz, Amy ;
Titus-Ernstoff, Linda ;
Bersch, Andrew J. ;
Stampfer, Meir J. ;
Baron, John A. ;
Egan, Kathleen M. ;
Willett, Walter C. .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2008, 17 (02) :379-386
[6]   Physical activity and survival after breast cancer diagnosis [J].
Holmes, MD ;
Chen, WY ;
Feskanich, D ;
Kroenke, CH ;
Colditz, GA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (20) :2479-2486
[7]   Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study [J].
Irwin, Melinda L. ;
Smith, Ashley Wilder ;
McTiernan, Anne ;
Ballard-Barbash, Rachel ;
Cronin, Kathy ;
Gilliland, Frank D. ;
Baumgartner, Richard N. ;
Baumgartner, Kathy B. ;
Bernstein, Leslie .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (24) :3958-3964
[8]   Randomized Controlled Trial of Aerobic Exercise on Insulin and Insulin-like Growth Factors in Breast Cancer Survivors: The Yale Exercise and Survivorship Study [J].
Irwin, Melinda L. ;
Varma, Katie ;
Alvarez-Reeves, Marty ;
Cadmus, Lisa ;
Wiley, Andrew ;
Chung, Gina G. ;
DiPietro, Loretta ;
Mayne, Susan T. ;
Yu, Herbert .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2009, 18 (01) :306-313
[9]   Relationship of obesity and physical activity with C-peptide, leptin, and insulin-like growth factors in breast cancer survivors [J].
Irwin, ML ;
McTiernan, A ;
Bernstein, L ;
Gilliland, FD ;
Baumgartner, R ;
Baumgartner, K ;
Ballard-Barbash, R .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2005, 14 (12) :2881-2888
[10]   Validation of the WHI brief physical activity questionnaire among women diagnosed with breast cancer [J].
Johnson-Kozlow, Marilyn ;
Rock, Cheryl L. ;
Gilpin, Elizabeth A. ;
Hollenbach, Kathryn A. ;
Pierce, John P. .
AMERICAN JOURNAL OF HEALTH BEHAVIOR, 2007, 31 (02) :193-202