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@ARTICLE{Jung:147497,
      author       = {A. Y. Jung$^*$ and S. Behrens$^*$ and M. Schmidt$^*$ and K.
                      Thoene and N. Obi and A. Hüsing$^*$ and A. Benner$^*$ and
                      K. Steindorf$^*$ and J. Chang-Claude$^*$},
      title        = {{P}re- to postdiagnosis leisure-time physical activity and
                      prognosis in postmenopausal breast cancer survivors.},
      journal      = {Breast cancer research},
      volume       = {21},
      number       = {1},
      issn         = {1465-542X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2019-02553},
      pages        = {117},
      year         = {2019},
      abstract     = {Physical activity (PA) before and after breast cancer
                      diagnosis has been reported to be associated with lower
                      mortality. However, whether changes in the activity after
                      diagnosis impact prognosis is unclear and has not received
                      much attention. This study aimed to examine pre- to
                      postdiagnosis leisure-time PA and breast cancer prognosis.We
                      used data from the MARIE study, a prospective
                      population-based patient cohort study of 3813 postmenopausal
                      breast cancer patients, aged 50-74 at diagnosis, recruited
                      from 2002 to 2005, re-interviewed in 2009, and followed up
                      until June 2015. Prediagnosis PA was assessed at
                      recruitment; postdiagnosis PA was assessed at re-interview
                      in 2009. To examine pre- to postdiagnosis change in PA,
                      women were categorized by pre- and postdiagnosis PA using a
                      cut-off of 7.5 MET-h/week for meeting PA recommendations and
                      combined into four groups: insufficiently active,
                      increasingly active, decreasingly active, and sufficiently
                      active. Cox regression models with delayed entry were used
                      to assess associations between pre- to postdiagnosis
                      patterns of PA and overall mortality (OM), breast cancer
                      mortality (BCM), and recurrence-free survival (RFS).
                      Additional analyses of pre- and postdiagnosis PA (no
                      activity (reference), low activity, sufficient activity)
                      with cancer outcomes, such as using a time-dependent model,
                      were performed. In total, 2042 patients were included in the
                      analyses.There were 206 deaths (114 from breast cancer)
                      after a median follow-up time of 6.0 years after the 2009
                      interview. Compared to insufficiently active women,
                      increasingly active women were at lower risk of OM, BCM, and
                      RFS (HR $(95\%CI)$ of 0.50 (0.31-0.82), 0.54 (0.30-1.00),
                      0.58 (0.40-0.84), respectively). In sufficiently active
                      women, associations for OM (0.75 (0.48-1.15)), BCM (0.61
                      (0.33-1.13)), and RFS 0.80 (0.57-1.14)) were similar to
                      increasingly active women but attenuated, and decreasingly
                      active women were not at lower risk for OM (0.91
                      (0.61-1.36)), BCM (0.80 (0.45-1.42)), and RFS (1.04
                      (0.76-1.43)). In time-dependent analyses, sufficient
                      activity vs. no activity was associated with better OM (0.73
                      (0.57-0.93)), BCM (0.64 (0.46-0.89)), and RFS (0.82
                      (0.68-0.99)). Low activity was not significantly associated
                      with prognosis.Our data support benefits for breast cancer
                      prognosis in being physically active pre- and postdiagnosis
                      particularly for women who were insufficiently active
                      prediagnosis.},
      cin          = {C020 / C110 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331 / I:(DE-He78)C110-20160331 /
                      I:(DE-He78)C060-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31694687},
      pmc          = {pmc:PMC6836389},
      doi          = {10.1186/s13058-019-1206-0},
      url          = {https://inrepo02.dkfz.de/record/147497},
}