Breast Cancer Research and Treatment

, Volume 123, Issue 2, pp 531–542 | Cite as

Past recreational physical activity, body size, and all-cause mortality following breast cancer diagnosis: results from the breast cancer family registry

  • Theresa H. M. Keegan
  • Roger L. Milne
  • Irene L. Andrulis
  • Ellen T. Chang
  • Meera Sangaramoorthy
  • Kelly-Anne Phillips
  • Graham G. Giles
  • Pamela J. Goodwin
  • Carmel Apicella
  • John L. Hopper
  • Alice S. Whittemore
  • Esther M. John
Epidemiology

Abstract

Few studies have considered the joint association of body mass index (BMI) and physical activity, two modifiable factors, with all-cause mortality after breast cancer diagnosis. Women diagnosed with invasive breast cancer (n = 4,153) between 1991 and 2000 were enrolled in the Breast Cancer Family Registry through population-based sampling in Northern California, USA; Ontario, Canada; and Melbourne and Sydney, Australia. During a median follow-up of 7.8 years, 725 deaths occurred. Baseline questionnaires assessed moderate and vigorous recreational physical activity and BMI prior to diagnosis. Associations with all-cause mortality were assessed using Cox proportional hazards regression, adjusting for established prognostic factors. Compared with no physical activity, any recreational activity during the 3 years prior to diagnosis was associated with a 34% lower risk of death [hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.51–0.85] for women with estrogen receptor (ER)-positive tumors, but not those with ER-negative tumors; this association did not appear to differ by race/ethnicity or BMI. Lifetime physical activity was not associated with all-cause mortality. BMI was positively associated with all-cause mortality for women diagnosed at age ≥50 years with ER-positive tumors (compared with normal-weight women, HR for overweight = 1.39, 95% CI: 0.90–2.15; HR for obese = 1.77, 95% CI: 1.11–2.82). BMI associations did not appear to differ by race/ethnicity. Our findings suggest that physical activity and BMI exert independent effects on overall mortality after breast cancer.

Keywords

Breast cancer Physical activity Body mass index Obesity Mortality 

Notes

Acknowledgments

The authors thank Enid Satariano and Jocelyn Koo (Northern California Cancer Center), Elaine Maloney and Nayana Weerasooriya (Cancer Care Ontario), and Maggie Angelakos, Judi Maskiell and Gillian Dite (University of Melbourne) for their assistance. The Breast Cancer Family Registry (Breast CFR) was supported by the National Cancer Institute, National Institutes of Health under RFA CA-95-011 and CA-06-503, and through cooperative agreements with members of the Breast CFR and Principal Investigators. The three registries contributing data to this analysis were supported by U01 CA69417 (Northern California Cancer Center), U01 CA69467 (Cancer Care Ontario), and U01 CA69638 (University of Melbourne). Kelly-Anne Phillips was supported by the Cancer Council Victoria Colebatch Clinical Research Fellowship. The content of this manuscript does not necessarily reflect the views or policies of the National Cancer Institute or any of the collaborating centers in the Breast CFR, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government or the Breast CFR.

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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Theresa H. M. Keegan
    • 1
    • 2
  • Roger L. Milne
    • 3
    • 4
  • Irene L. Andrulis
    • 5
    • 6
  • Ellen T. Chang
    • 1
    • 2
  • Meera Sangaramoorthy
    • 1
  • Kelly-Anne Phillips
    • 7
    • 8
  • Graham G. Giles
    • 9
  • Pamela J. Goodwin
    • 5
    • 10
  • Carmel Apicella
    • 4
  • John L. Hopper
    • 4
  • Alice S. Whittemore
    • 2
  • Esther M. John
    • 1
    • 2
  1. 1.Northern California Cancer CenterFremontUSA
  2. 2.Division of Epidemiology, Department of Health Research and PolicyStanford University School of MedicineStanfordUSA
  3. 3.Genetic & Molecular Epidemiology Group, Human Cancer Genetics ProgramSpanish National Cancer Center (CNIO)MadridSpain
  4. 4.Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population HealthThe University of MelbourneMelbourneAustralia
  5. 5.Samuel Lunenfeld Research Institute, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  6. 6.Ontario Cancer Genetics NetworkCancer Care OntarioTorontoCanada
  7. 7.Division of Haematology and Medical OncologyPeter MacCallum Cancer CentreMelbourneAustralia
  8. 8.Department of Medicine, St. Vincent’s HospitalThe University of MelbourneMelbourneAustralia
  9. 9.Cancer Epidemiology CentreThe Cancer Council VictoriaCarltonAustralia
  10. 10.Departments of Medicine and Public Health Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada

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