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Association between physical activity and mortality in breast cancer: a meta-analysis of cohort studies

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Abstract

Previous studies concerning the association between physical activity (PA) and mortality in breast cancer yielded mixed results. We investigated the association by performing a meta-analysis of all available studies. Relevant studies were identified by searching PubMed and EMBASE to January 2014. We calculated the summary relative risk (RR) and 95 % confidence intervals (CIs) using random-effects models. The dose–response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression. Sixteen cohort studies involving 42,602 patients of breast cancer were selected for meta-analysis. The analyses showed that patients who participated in any amount of PA before diagnosis had a RR of 0.82 (95 % CI 0.74–0.91) for breast cancer-specific mortality (vs. low PA). Those who participated in high PA and moderate PA before diagnosis had a RR of breast cancer-specific mortality of 0.81 (95 % CI 0.72–0.90) and 0.83 (95 % CI 0.73–0.94), respectively. Similar inverse associations of prediagnosis PA were found for all-cause mortality. Postdiagnosis PA on breast cancer-specific and all-cause mortality also showed the same results. Stratifying by body mass index (<25 vs. ≥25) or menopausal status, all the subgroups experienced benefits with PA, with a stronger mortality reduction among overweight women than normal weight women and among postmenopausal women than premenopausal women. A linear and significant dose–response association was only found for breast cancer-specific or all-cause mortality and prediagnosis PA (P for nonlinearity = 0.07 and 0.10, respectively). In conclusion, both prediagnosis and postdiagnosis PA were associated with reduced breast cancer-specific mortality and all-cause mortality.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (81272470).

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The authors declare no conflict of interest.

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Authors and Affiliations

  1. Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China

    Shanliang Zhong, Tengfei Ma, Xiaohui Zhang & Jianhua Zhao

  2. Clinical College of Nanjing Medical University, Nanjing, 210029, China

    Tianchi Jiang

  3. Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing, 210009, China

    Jinhai Tang

  4. The Fourth Clinical College of Nanjing Medical University, Nanjing, 210009, China

    Weixian Chen & Mengmeng Lv

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  1. Shanliang Zhong
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Correspondence to Jianhua Zhao.

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Zhong, S., Jiang, T., Ma, T. et al. Association between physical activity and mortality in breast cancer: a meta-analysis of cohort studies. Eur J Epidemiol 29, 391–404 (2014). https://doi.org/10.1007/s10654-014-9916-1

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