Abstract
Moderate-to-vigorous intensity physical activity (MVPA) reduces breast cancer risk, although the effects of MVPA in different settings across the life course and how they may differ by menopausal status are unclear. This gap was addressed using data from a case–control study of 1,110 incident breast cancer cases and 1,172 cancer-free controls, frequency matched by age, from Vancouver and Kingston, Canada. In Vancouver, cases were recruited from the British Columbia Cancer Registry and controls from the Screening Mammography Program of British Columbia and in Kingston cases and controls were recruited from a breast assessment center. Lifetime leisure-time, household, and occupational MVPA energy expenditures were assessed in an open-ended questionnaire and mean weekly metabolic equivalent hours (MET-h/week) were calculated for the age periods 12–17, 18–34, 35–49, and ≥50 years and for the total lifetime. Odds ratios were estimated separately for pre- and for post-menopausal women using unconditional logistic regression. Among post-menopausal women, each of >22.9 MET-h/week of mean lifetime leisure-time MVPA (equivalent to running for 3 h) and >61.1 MET-h/week of mean lifetime household MVPA (equivalent to 24 h of moderate household work) reduced breast cancer risk by 40 %, compared to 0 MET-h/week of each. The respective ORs were 0.63 (95 % CI 0.42–0.94) and 0.58 (95 % CI 0.43–0.79). Among post-menopausal women, leisure-time MVPA after age 35 was more strongly associated with reduced breast cancer risk than MVPA in early life, while household MVPA was associated with reduced risk at all adulthood age periods. The weekly volume of leisure-time MVPA required to reduce post-menopausal breast cancer risk was consistent with amount recommended in the World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention.
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Abbreviations
- MVPA:
-
Moderate-to-vigorous intensity physical activity
- MEBC:
-
Molecular epidemiology of breast cancer
- BC:
-
British Columbia
- ON:
-
Ontario
- MET:
-
Metabolic equivalent
- OR:
-
Odds ratio
- CI:
-
Confidence interval
References
Howlander N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, et al (2013) SEER Cancer Statistics Review, 1975–2010, National Cancer Institute, Bethesda, MD. http://seer.cancer.gov/csr/1975_2010/, based on November 2012 SEER data submission, posted to the SEER website, April 2013. Accessed 06 May 2013
John R, Ross H (2010) The global economic cost of cancer. Atlanta, Georgia
Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV et al (2012) American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67
Lynch BM, Neilson HK, Friedenreich CM (2011) Physical activity and breast cancer prevention. In: Courneya KS, Friedenreich C (eds) Physical activity and cancer. Springer, Berlin, pp 13–42
World Health Organization (2010) Global recommendations on physical activity for health. Switzerland, Geneva
World Cancer Research Fund (1997) Food, nutrition, and the prevention of cancer: a global perspective. AICR, Washington
Friedenreich CM, Cust AE (2008) Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br J Sports Med 42:636–647
Monninkhof E, Elias S, Vlems F, van der Tweel I, Schiut A, Voskuil D et al (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18:137–157
Friedenreich CM (2010) The role of physical activity in breast cancer etiology. Semin Oncol 37:297–302
Pettee Gabriel KK, Morrow JR, Woolsey A-LT (2012) Framework for physical activity as a complex and multidimensional behavior. J Phys Act Health 9:S11–S18
Holtermann A, Hansen JV, Burr H, Søgaard K, Sjøgaard G (2012) The health paradox of occupational and leisure-time physical activity. Br J Sports Med 46:291–295
Friedenreich CM, Courneya KS, Bryant HE (2001) Influence of physical activity in different age and life periods on the risk of breast cancer. Epidemiology 12:604–612
Lahmann PH, Friedenreich C, Schuit AJ, Salvini S, Allen NE, Key TJ et al (2007) Physical activity and breast cancer risk: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 16:36–42
John EM, Horn-Ross PL, Koo J (2003) Lifetime physical activity and breast cancer risk in a multiethnic population: the San Francisco bay area breast cancer study. Cancer Epidemiol Biomarkers Prev 12:1143–1152
Steindorf K, Schmidt M, Kropp S, Chang-Claude J (2003) Case–control study of physical activity and breast cancer risk among premenopausal women in Germany. Am J Epidemiol 15(157):121–130
Steindorf K, Ritte Rebecca, Eomois P-P, Lukanova A, Tjonneland A, Johnsen NF et al (2012) Physical activity and risk of breast cancer overall and by hormone receptor status: the European prospective investigation into cancer and nutrition. Int J Cancer 132:1667–1678
Peplonska B, Lissowska J, Hartman TJ, Szeszenia-Dabrowska N, Blair A, Zatonski W et al (2008) Adulthood lifetime physical activity and breast cancer. Epidemiology 19:226–236
Kruk J (2007) Lifetime physical activity and the risk of breast cancer: a case–control study. Cancer Detect Prev 31:18–28
Schmidt ME, Steindorf K, Mutschelknauss E, Slanger T, Kropp S, Obi N et al (2008) Physical activity and postmenopausal breast cancer: effect modification by breast cancer subtypes and effective periods in life. Cancer Epidemiol Biomarkers Prev 17:3402–3410
Sprague BL, Trentham-Diaz A, Newcomb PA, Titus-Ernstoff L, Hampton JM, Egan KM (2007) Lifetime recreational and occupational physical activity and risk of in situ and invasive breast cancer. Cancer Epidemiol Biomarkers Prev 16:236–243
Moradi T, Hans-Olav A, Ekbom A, Wedrén S, Terry P, Floderus B et al (2002) Physical activity and risk for breast cancer: a prospective cohort study among Swedish twins. Int J Cancer 100:76–81
Tehard B, Friedenreich CM, Oppert J-M, Clavel-Chapelon F (2006) Effect of physical activity on women at increased risk of breast cancer: results from the E3 N cohort study. Cancer Epidemiol Biomarkers Prev 15:57–64
Matthews CE, Shu X-O, Jin F, Dai Q, Hebert JR, Ruan Z-X et al (2001) Lifetime physical activity and breast cancer risk in the Shanghai breast cancer study. Br J Cancer 84:994–1001
Csizmadi I, Lo Siou G, Friedenreich CM, Owen N, Robson PJ (2011) Hours spent and energy expended in physical activity domains: results from the tomorrow project cohort in Alberta, Canada. Int J Behav Nutr Phys Act 8:110
Sternfeld B, Ainsworth BE, Quesenberry CP (1999) Physical activity patterns in a diverse population of women. Prev Med 28:313–323
Lynch BM, Friedenreich CM, Vallance JK, Eakin EG, Owen N (2011) Associations of objectively assessed physical activity and sedentary time with biomarkers of breast cancer risk in postmenopausal women: findings from NHANES (2003–2006). Breast Cancer Res Treat 130:183–194
Friedenreich CM (2011) Physical activity and breast cancer: review of the epidemiologic evidence and biological mechanisms. In: Senn H-J, Otto F (eds) Clinical cancer prevention. Springer, Berlin Heidelberg, pp 125–139
Yang D, Bernstein L, Wu AH (2003) Physical activity and breast cancer risk among Asian–American women in Los Angeles: a case–control study. Cancer 15(97):2565–2575
Peters TM, Moore SC, Gierach GL, Wareham NJ, Ekelund U, Hollenbeck AR et al (2009) Intensity and timing of physical activity in relation to postmenopausal breast cancer risk: the prospective NIH-AARP diet and health study. BMC Cancer 9:1–14
Leitzmann MF, Moore SC, Peters TM, Lacey JV, Schatzkin A, Schairer C et al (2008) Prospective study of physical activity and risk of postmenopausal breast cancer. Breast Cancer Res 10:R92
Friedenreich CM, Courneya KS, Bryant HE (2001) Relation between intensity of physical activity and breast cancer risk reduction. Med Sci Sport Exerc 33:1538–1545
Eliassen AH, Hankinson SE, Rosner B, Holmes MD, Willett WC (2010) Physical activity and risk of breast cancer among postmenopausal women. Arch Intern Med 170:1758–1764
Verloop J, Rookus MA, van der Kooy K, van Leeuwen FE (2000) Physical activity and breast cancer risk in women aged 20–54 years. J Natl Cancer Inst 19(92):128–135
McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL et al (2003) Recreational physical activity and the risk of breast cancer in postmenopausal women: the women’s health initiative cohort study. JAMA 290(10):1331–1336
Maruti SS, Willett WC, Feskanich D, Rosner B, Colditz GA (2008) A prospective study of age-specific physical activity and premenopausal breast cancer. J Natl Cancer Inst 100:728–737
Jr Paffenbarger, Ralph S, Kampert JB, Chang H-G (1980) Characteristics that predict risk of breast cancer before and after the menopause. Am J Epidemiol 112:258–268
Friedenreich C, Courneya K, Bryant H (1998) The lifetime total physical activity questionnaire: development and reliability. Med Sci Sport Exerc 30:266–274
Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sport Exerc 32:S498–S516
Smigal C, Jemal A, Ward E, Cokkinides V, Smith R, Howe HL et al (2006) Trends in breast cancer by race and ethnicity: update 2006. CA Cancer J Clin 56:168–183
Mcpherson K, Steel CM, Dixon JM (2000) Breast cancer: epidemiology, risk factors, and genetics. BMJ 321:624–628
Rothman K, Greenland S (1998) Modern epidemiology, 2nd edn. Lippincott-Raven, Philadelphia
Steindorf K, Ritte R, Tjonneland A, Johnsen NF, Overvad K, Nautrup Ostergaard J et al (2012) Prospective study on physical activity and risk of in situ breast cancer. Cancer Epidemiol Biomarkers Prev 21:2209–2219
Lee I-M (2003) Physical activity and cancer prevention: data from epidemiologic studies. Med Sci Sport Exerc 35:1823–1827
Speck RM, Schmitz KH, Lee I-M, McTiernan A (2011) Epidemiology of physical activity and cancer risk. In: McTiernan A (ed) Physical activity, dietary calorie restriction, and cancer. Springer, New York, pp 25–53
Friedenreich CM, Woolcott CG, Mctiernan A, Terry T, Brant R, Ballard-Barbash R et al (2011) Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes 35:427–435
Friedenreich CM, Neilson HK, Woolcott CG, Mctiernan A, Wang Q, Ballard-Barbash R et al (2011) Changes in insulin resistance indicators, IGFs, and adipokines in a year-long trial of aerobic exercise in postmenopausal women. Endocr-Relat Cancer 18:357–369
Friedenreich C, Woolcott C, McTiernan A, Ballard-Barbash R, Brant R, Stanczyk F et al (2010) Alberta physical activity and breast cancer prevention trial: sex hormone changes in a year-long exercise intervention among postmenopausal women. J Clin Oncol 28:1458–1466
Friedenreich CM, Neilson HK, Woolcott CG, Wang Q, Yasui Y, Brant RF et al (2011) Mediators and moderators of the effects of a year-long exercise intervention on endogenous sex hormones in postmenopausal women. Cancer Causes Control 11:1365–1373
Nelson LR, Bulun SE (2001) Estrogen production and action. J Am Acad Dermatol 45:S116–S124
Kruk J (2009) Lifetime occupational physical activity and the risk of breast cancer: a case–control study. Asian Pac J Cancer Prev 10:443–448
George SM, Irwin ML, Matthews CE, Mayne ST, Gail MH, Moore SC et al (2010) Beyond recreational physical activity: examining occupational and household activity, transportation activity, and sedentary behavior in relation to postmenopausal breast cancer risk. Am J Public Health 100:2288–2295
Coogan PF, Aschengrau A (1999) Occupational physical activity and breast cancer risk in the upper Cape Cod cancer incidence study. Am J Int Med 36:279–285
Dorn J, Vena J, Brasure J, Freudenheim J, Graham S (2003) Lifetime physical activity and breast cancer risk in pre- and postmenopausal women. Medi Sci Sport Exerc 35:278–285
Klesges R, Eck L, Mellon M, Fulliton W, Somes G, Hanson C (1990) The accuracy of self-reports of physical activity. Med Sci Sport Exerc 22:690–697
BC Cancer Agency (2011) British Columbia 2011 regional cancer report. Section 5: screening and diagnosis. Vancouver
Shields M, Wilkins K (2009) An update on mammography use in Canada. Statistics Canada Catalogue no. 82–003-XPE. Health Rep 20:1–13
Acknowledgments
This study was funded by the Canadian Institutes of Health Research/Canadian Breast Cancer Research Alliance. The authors thank Dr. Chris Bajdik for contributions to study design, Dr. Christine Friedenreich for permission to adapt the physical activity questionnaire, and Dr. Anne Grundy, Derrick Lee, and Dr. Matt Parkinson for assistance with data management. Lindsay Kobayashi was supported by an Ontario Graduate Scholarship from the Ontario Ministry of Training, Colleges, and Universities, and a studentship from the Queen’s University Terry Fox Foundation Training Program in Transdisciplinary Cancer Research in Partnership with CIHR.
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The authors declare that they have no conflict of interest.
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Kobayashi, L.C., Janssen, I., Richardson, H. et al. Moderate-to-vigorous intensity physical activity across the life course and risk of pre- and post-menopausal breast cancer. Breast Cancer Res Treat 139, 851–861 (2013). https://doi.org/10.1007/s10549-013-2596-9
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DOI: https://doi.org/10.1007/s10549-013-2596-9
Keywords
- Physical activity
- Breast cancer
- Menopausal status
- Case–control
- Women