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The After Breast Cancer Pooling Project: rationale, methodology, and breast cancer survivor characteristics

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Abstract

The After Breast Cancer Pooling Project was established to examine the role of physical activity, adiposity, dietary factors, supplement use, and quality of life (QOL) in breast cancer prognosis. This paper presents pooled and harmonized data on post-diagnosis lifestyle factors, clinical prognostic factors, and breast cancer outcomes from four prospective cohorts of breast cancer survivors (three US-based and one from Shanghai, China) for 18,314 invasive breast cancer cases diagnosed between 1976 and 2006. Most participants were diagnosed with stage I-II breast cancer (84.7%). About 60% of breast tumors were estrogen receptor (ER)+/progesterone receptor (PR)+; 21% were ER−/PR−. Among 8,118 participants with information on HER-2 tumor status, 74.8% were HER-2− and 18.5% were HER-2+. At 1–2 years post-diagnosis (on average), 17.9% of participants were obese (BMI ≥ 30 kg/m2), 32.6% were overweight (BMI 25–29 kg/m2), and 59.9% met the 2008 Physical Activity Guidelines for Americans (≥2.5 h per week of moderate activity). During follow-up (mean = 8.4 years), 3,736 deaths (2,614 from breast cancer) and 3,564 recurrences have been documented. After accounting for differences in year of diagnosis and timing of post-diagnosis enrollment, five-year overall survival estimates were similar across cohorts. This pooling project of 18,000 breast cancer survivors enables the evaluation of associations of post-diagnosis lifestyle factors, QOL, and breast cancer outcomes with an adequate sample size for investigation of heterogeneity by hormone receptor status and other clinical predictors. The project sets the stage for international collaborations for the investigation of modifiable predictors for breast cancer outcomes.

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Acknowledgments

The authors thank investigators and staff members of the research teams and study participants for their contributions and support for the study.

Financial support

This study was supported by the National Cancer Institute (Grant number 3R01CA118229-03S1). The parent grants for each individual cohort included in the After Breast Cancer Pooling Project are as follows: SBCSS (Department of Defense, DAMD 17-02-1-0607 and National Cancer Institute, R01 CA118229), WHEL (Susan G. Komen Foundation, #KG100988), LACE (National Cancer Institute, R01 CA129059), and NHS (P01 CA87969).

Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37203-1738, USA

    Sarah J. Nechuta, Zhi Chen & Xiao Ou Shu

  2. Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA

    Bette J. Caan, Marilyn L. Kwan & Erin Weltzien

  3. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA

    Wendy Y. Chen & Elizabeth M. Poole

  4. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA

    Wendy Y. Chen

  5. Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, San Diego, CA, 92093-0901, USA

    Shirley W. Flatt, Ruth E. Patterson & John P. Pierce

  6. Shanghai Municipal Center for Disease Control and Prevention, 200336, Shanghai, China

    Wei Lu

  7. Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, IMPH, Nashville, TN, 37203-1738, USA

    Xiao Ou Shu

Authors
  1. Sarah J. Nechuta
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  2. Bette J. Caan
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  3. Wendy Y. Chen
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  4. Shirley W. Flatt
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  5. Wei Lu
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  6. Ruth E. Patterson
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  7. Elizabeth M. Poole
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  8. Marilyn L. Kwan
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  9. Zhi Chen
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  10. Erin Weltzien
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  11. John P. Pierce
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  12. Xiao Ou Shu
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Correspondence to Xiao Ou Shu.

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Nechuta, S.J., Caan, B.J., Chen, W.Y. et al. The After Breast Cancer Pooling Project: rationale, methodology, and breast cancer survivor characteristics. Cancer Causes Control 22, 1319–1331 (2011). https://doi.org/10.1007/s10552-011-9805-9

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  • DOI: https://doi.org/10.1007/s10552-011-9805-9

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