Breast Cancer Research and Treatment

, Volume 95, Issue 2, pp 171–178 | Cite as

Pre-diagnosis physical activity and mammographic density in breast cancer survivors

  • Melinda L. Irwin
  • Erin J. Aiello
  • Anne McTiernan
  • Richard N. Baumgartner
  • Kathy B. Baumgartner
  • Leslie Bernstein
  • Frank D. Gilliland
  • Rachel Ballard-Barbash



To investigate the association between physical activity (PA) and mammographic density in the year before diagnosis in a population-based sample of 474 women diagnosed with stage 0–IIIA breast cancer and enrolled in the Health, Eating, Activity, and Lifestyle Study.


We collected information on PA during an interview administered at a baseline visit scheduled within the first year after diagnosis. Participants recalled the type, duration, and frequency of different PAs for the year prior to their diagnosis. Dense area and percent density were estimated, from mammograms imaged approximately 1 year before diagnosis, as a continuous measure using a computer-assisted software program. Analysis of covariance methods were used to obtain mean density across PA tertiles adjusted for confounders. We stratified analyses by menopausal status and body mass index (BMI) because these factors strongly influence density.


We observed a statistically significant decline in mammographic dense area (p for trend = 0.046) and percent density (p for trend = 0.026) with increasing level of sports/recreational PA in postmenopausal women with a BMI ≥30 kg/m2. Conversely, in premenopausal women with a BMI <‰30 kg/m2, we observed a statistically significant increase in percent density with increasing level of sports/recreational PA (p for trend = 0.037).


Both mammographic dense area and percent density are inversely related to level of sports/recreational PA in obese postmenopausal women. Increasing PA among obese postmenopausal women may be a reasonable intervention approach to reduce mammographic density.


body fat breast cancer exercise obesity weight 


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This study was supported through NCI contracts N01-CN-75036-20, NO1-CN-05228, NO1-PC-67010, and training grant T32 CA09661. A portion of this work was conducted through the Clinical Research Center at the University of Washington and supported by the National Institutes of Health, Grant M01-RR-00037, and the University of New Mexico, NCRR M01-RR-0997. We would like to thank Kristin LaCroix, Shelley Tworoger, and Lynda McVarish for their contributions to the HEAL study, as well as the HEAL participants for their ongoing dedication to this study.


  1. 1.
    Boyd NF, Lockwood GA, Byng JW, et al. Mammographic densities and breast cancer risk CEBP7:1133–1144, 1998Google Scholar
  2. 2.
    Oza AM, Boyd NF, Mammographic parenchymal patterns: a marker of breast cancer risk Epidemiol Rev15:196–208, 1993PubMedGoogle Scholar
  3. 3.
    Byrne C, Colditz GA, Willett WC, et al. Plasma insulin-like growth factor, IGF-binding protein 3, and mammographic density Cancer Res60:3744–3748, 2000PubMedGoogle Scholar
  4. 4.
    Berglund G, Anthropometry, physical activity and cancer of the breast and colon IARC Sci Publ156:237–241, 2002PubMedGoogle Scholar
  5. 5.
    Vachon CM, Kuni CC, Anderson K, et al. Association of mammographically defined percent breast density with epidemiologic risk factors for breast cancer Cancer Causes Control 11:653–662, 2000CrossRefPubMedGoogle Scholar
  6. 6.
    Gram IT, Funkhouser E, Tabar L, Moderate physical activity in relation to mammographic patterns CEBP8:117–122, 1999Google Scholar
  7. 7.
    McTiernan A, Tworoger SS, Ulrich CM, et al. 2004 Effect of exercise on serum estrogens in postmenopausal women a 12-month randomized clinical trial. Cancer Res 64:2923–2928CrossRefPubMedGoogle Scholar
  8. 8.
    Irwin ML, Crumley D, McTiernan A, et al. Physical activity levels before and after a diagnosis of breast carcinoma: The Health, Eating, Activity, and Lifestyle (HEAL) Study Cancer 97:1746–1757:2003CrossRefPubMedGoogle Scholar
  9. 9.
    Irwin ML, McTiernan A, Bernstein L, Gilliland G, Baumgartner R, Baumgartner K, Ballard-Barbash R, Physical activity levels among breast cancer survivors Med Sci Sports Exer 36(9): 1484–1491, 2004Google Scholar
  10. 10.
    McTiernan A, Rajan B, Tworoger S, et al. Adiposity and sex hormones in postmenopausal breast cancer survivors J Clin Oncol 21(10):1961–1966:2003CrossRefPubMedGoogle Scholar
  11. 11.
    Kriska A, Modifiable activity questionnaire Med Sci Sports Exer29:S73–S78:1997Google Scholar
  12. 12.
    Ainsworth B, Haskell W, Whitt M, et al. Compendium of physical activities: an update of activity codes and MET intensities Med Sci Sports Exer 32:S498–S516:2000CrossRefPubMedGoogle Scholar
  13. 13.
    Boyd NF, Byng JW, Jong RA, et al. Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study JNCI87:670–675, 1995PubMedCrossRefGoogle Scholar
  14. 14.
    National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults – the evidence report. Obesity Res. 6(Suppl 2):S51–S209, 1998Google Scholar
  15. 15.
    Pate RR, Pratt M, Blair S, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine JAMA 2735:402–407, 1995CrossRefPubMedGoogle Scholar
  16. 16.
    Institute of Medicine Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Protein and Amino Acids (Macronutrients): A Report of the Panel on Macronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Washington, DC National Academies Press 2002 pp. 12–23Google Scholar
  17. 17.
    Cleary MP, Maihle NJ, The role of body mass index in the relative risk of developing premenopausal versus postmenopausal breast cancer Proc Soc Exp Biol Med 2161: 28–43, 1997PubMedGoogle Scholar
  18. 18.
    Lopez P, Van Horn L, Colangelo LA, et al. Physical inactivity and percent breast density among Hispanic women Int J cancer 1076:1012–1016, 2003CrossRefPubMedGoogle Scholar
  19. 19.
    Marchesoni D, Driul L, Ianni A et al.: Postmenopausal hormone therapy and mammographic breast density. Maturitas 2005 June 3Google Scholar
  20. 20.
    Boyd NF, Stone J, Martin LJ, et al. The association of breast mitogens with mammographic densities Br J Cancer 878: 876–882, 2002CrossRefPubMedGoogle Scholar
  21. 21.
    White J, Breast density and cancer risk: what is the relationship? JNCI 92:443, 2000CrossRefPubMedGoogle Scholar
  22. 22.
    Potischman N, Swanson CA, Siiteri P, Hoover RN, Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status JNCI 88:756–758, 1996PubMedCrossRefGoogle Scholar
  23. 23.
    White E, Velentgas P, Mandelson MT, Lehman CD, Elmore JG, Porter P, Yasui Y, Taplin SH, Variation in mammographic breast density by time in menstrual cycle among women aged 40–49 years J Natl Cancer Inst 9012:906–910, 1998CrossRefPubMedGoogle Scholar
  24. 24.
    Pawluczyk O, Augustine B, Yaffe M, Rico D, Yang J, Mawdsley G, Boyd N, A volumetric method for estimation of breast density on digitized screen-film mammograms Med Phys 303: 352–364, 2003CrossRefPubMedGoogle Scholar
  25. 25.
    Ursin G, Palla SL, Reboussin BA, Slone S, Wasilauskas C, Pike MC, Greendale GA, Post-treatment change in serum estrone predicts mammographic percent density changes in women who received combination estrogen and progestin in the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial JCO224: 2842–2848, 2004CrossRefGoogle Scholar
  26. 26.
    Irwin ML, Yasui Y, Ulrich C, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial JAMA 289(3):323–330:2003CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Melinda L. Irwin
    • 1
  • Erin J. Aiello
    • 2
  • Anne McTiernan
    • 3
  • Richard N. Baumgartner
    • 4
  • Kathy B. Baumgartner
    • 4
  • Leslie Bernstein
    • 5
  • Frank D. Gilliland
    • 5
  • Rachel Ballard-Barbash
    • 6
  1. 1.Department of Epidemiology and Public HealthYale School of MedicineNew HavenUSA
  2. 2. Center for Health StudiesGroup Health CooperativeSeattleUSA
  3. 3.The Fred Hutchinson Cancer Research CenterSeattleUSA
  4. 4.Cancer Research & Treatment Center, Department of Internal MedicineUniversity of New MexicoAlbuquerqueNew Mexico
  5. 5.Department of Preventive MedicineUniversity of Southern CaliforniaLos AngelesUSA
  6. 6.Applied Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA

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