Abstract
Studies consistently demonstrate that physical activity is inversely associated with postmenopausal breast cancer. Whether this association is stronger among non-hormone users or former users of menopausal hormone therapy (HT) is of interest given the marked decline in HT use since 2002. The Women’s Contraceptive and Reproductive Experiences Study, a population-based case–control study of invasive breast cancer, recruited white women and black women ages 35–64 years and collected histories of lifetime recreational physical activity and HT use including estrogen-alone therapy (ET) and estrogen plus progestin therapy (EPT). Among postmenopausal women (1,908 cases, 2,013 control participants), breast cancer risk declined with increasing levels of lifetime physical activity among never HT users; among short-term HT users (fewer than 5 years); and among current ET users; P trend values ranged from 0.004 to 0.016. In contrast, physical activity had no significant association with risk among long-term and past HT users and among current EPT users. No statistical evidence of heterogeneity was demonstrated for duration or currency of HT use. Breast cancer risk decreases with increasing lifetime physical activity levels among postmenopausal women who have not used HT, have used HT for less than 5 years, or are current ET users, yet this study was unable to demonstrate statistically that HT use modifies the relationship between physical activity and breast cancer. With profound changes in HT use occurring since 2002, it will be important in future studies to learn whether or not any association between physical activity and breast cancer among former HT users is a function of time since last HT use.
References
Leitzmann MF, Moore SC, Peters TM et al (2008) Prospective study of physical activity and risk of postmenopausal breast cancer. Breast Cancer Res 10:R92
McTiernan A, Kooperberg C, White E et al (2003) Recreational physical activity and the risk of breast cancer in postmenopausal women: the women’s health initiative cohort study. Jama 290:1331–1336
Tehard B, Friedenreich CM, Oppert JM, 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
Neilson HK, Friedenreich CM, Brockton NT, Millikan RC (2009) Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev 18:11–27
van Gils CH, Peeters PH, Schoenmakers MC et al (2009) Physical activity and endogenous sex hormone levels in postmenopausal women: a cross-sectional study in the prospect-EPIC cohort. Cancer Epidemiol Biomarkers Prev 18:377–383
Hing E, Brett KM (2006) Changes in US prescribing patterns of menopausal hormone therapy, 2001–2003. Obstet Gynecol 108:33–40
Hersh AL, Stefanick ML, Stafford RS (2004) National use of postmenopausal hormone therapy: annual trends and response to recent evidence. Jama 291:47–53
Haas JS, Kaplan CP, Gerstenberger EP, Kerlikowske K (2004) Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results. Ann Intern Med 140:184–188
Lee SA, Ross RK, Pike MC (2005) An overview of menopausal oestrogen-progestin hormone therapy and breast cancer risk. Br J Cancer 92:2049–2058
Prentice RL, Chlebowski RT, Stefanick ML et al (2008) Estrogen plus progestin therapy and breast cancer in recently postmenopausal women. Am J Epidemiol 167:1207–1216
Howard RA, Leitzmann MF, Linet MS, Freedman DM (2009) Physical activity and breast cancer risk among pre- and postmenopausal women in the US radiologic technologists cohort. Cancer Causes Control 20:323–333
Patel AV, Callel EE, Bernstein L, Wu AH, Thun MJ (2003) Recreational physical activity and risk of postmenopausal breast cancer in a large cohort of US women. Cancer Causes Control 14:519–529
Slattery ML, Edwards S, Murtaugh MA et al (2007) Physical activity and breast cancer risk among women in the southwestern United States. Ann Epidemiol 17:342–353
WHO (1990) International classification of diseases for oncology, 2nd edn. World Health Organization, Geneva, Switzerland
Marchbanks PA, McDonald JA, Wilson HG et al (2002) The NICHD women’s contraceptive and reproductive experiences study: methods and operational results. Ann Epidemiol 12:213–221
Bernstein L, Patel AV, Ursin G et al (2005) Lifetime recreational exercise activity and breast cancer risk among black women and white women. J Natl Cancer Inst 97:1671–1679
Ainsworth BE, Haskell WL, Whitt MC et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:S498–S504
Dallal CM, Sullivan-Halley J, Ross RK et al (2007) Long-term recreational physical activity and risk of invasive and in situ breast cancer: the California teachers study. Arch Intern Med 167:408–415
Gammon MD, Schoenberg JB, Britton JA et al (1998) Recreational physical activity and breast cancer risk among women under age 45 years. Am J Epidemiol 147:273–280
Moore DB, Folsom AR, Mink PJ, Hong CP, Anderson KE, Kushi LH (2000) Physical activity and incidence of postmenopausal breast cancer. Epidemiology 11:292–296
McTiernan A, Stanford JL, Weiss NS, Daling JR, Voigt LF (1996) Occurrence of breast cancer in relation to recreational exercise in women age 50–64 years. Epidemiology 7:598–604
Rockhill B, Willett WC, Hunter DJ, Manson JE, Hankinson SE, Colditz GA (1999) A prospective study of recreational physical activity and breast cancer risk. Arch Intern Med 159:2290–2296
Friedenreich CM, Bryant HE, Courneya KS (2001) Case–control study of lifetime physical activity and breast cancer risk. Am J Epidemiol 154:336–347
Lahmann PH, Friedenreich C, Schuit AJ et al (2007) Physical activity and breast cancer risk: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 16:36–42
Peters TM, Schatzkin A, Gierach GL et al (2009) Physical activity and postmenopausal breast cancer risk in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev 18:289–296
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dieli-Conwright, C.M., Sullivan-Halley, J., Patel, A. et al. Does hormone therapy counter the beneficial effects of physical activity on breast cancer risk in postmenopausal women?. Cancer Causes Control 22, 515–522 (2011). https://doi.org/10.1007/s10552-010-9719-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-010-9719-y