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000265702 1001_ $$0P:(DE-He78)74a6af8347ec5cbd4b77e562e10ca1f2$$aTurzanski-Fortner, Renée$$b0$$eFirst author$$udkfz
000265702 245__ $$aPhysical activity and breast cancer survival: results from the Nurses' Health Studies.
000265702 260__ $$aOxford$$bOxford University Press$$c2023
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000265702 520__ $$aPhysical activity is generally associated with better outcomes following diagnosis; however, few studies have evaluated change in pre- to postdiagnosis activity and repeated measures of activity by intensity and type.We evaluated physical activity and survival following a breast cancer diagnosis in the Nurses' Health Study and Nurses' Health Study II (n = 9308 women, n = 1973 deaths). Physical activity was evaluated as updated cumulative average of metabolic equivalent of task (MET)-h/wk (assigned per activity based on duration and intensity) and change in pre- to postdiagnosis activity. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).Higher postdiagnosis activity was inversely associated with breast cancer-specific mortality in categories from ≥9 MET-h/wk (vs <3 MET h/wk, HR≥9 to <18 = 0.74 [95% CI = 0.55 to 0.99]; HR≥27 = 0.69 [95% CI = 0.50 to 0.95]; Ptrend = .04) and all-cause mortality from ≥3 MET-h/wk (HR≥3 to <9 = 0.73 [95% CI = 0.61 to 0.88]; HR≥27 = 0.51 [95% CI = 0.41 to 0.63]; Ptrend < .001). Associations were predominantly observed for estrogen receptor-positive tumors and in postmenopausal women. Walking was associated with lower risk of all-cause mortality (≥9 vs <3 MET-h/wk, HR= 0.69 [95% CI = 0.57 to 0.84]) as was strength training. Relative to stable activity pre- to postdiagnosis (±3 MET-h/wk), increases from ≥3 to 9 MET-h/wk were associated with lower all-cause mortality risk (Ptrend < .001). Results were robust to adjustment for prediagnosis physical activity.Physical activity was associated with lower risk of death following diagnosis. Increased pre- to postdiagnosis activity corresponding to at least 1-3 h/wk of walking was associated with lower risk of death. These results provide further impetus for women to increase their activity after a breast cancer diagnosis, though reverse causation cannot be fully excluded.
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000265702 650_2 $$2MeSH$$aHumans
000265702 650_2 $$2MeSH$$aFemale
000265702 650_2 $$2MeSH$$aBreast Neoplasms: diagnosis
000265702 650_2 $$2MeSH$$aExercise
000265702 650_2 $$2MeSH$$aProportional Hazards Models
000265702 650_2 $$2MeSH$$aProspective Studies
000265702 650_2 $$2MeSH$$aNurses
000265702 7001_ $$aBrantley, Kristen D$$b1
000265702 7001_ $$aTworoger, Shelley S$$b2
000265702 7001_ $$00000-0003-2306-8668$$aTamimi, Rulla M$$b3
000265702 7001_ $$00000-0001-6907-0056$$aRosner, Bernard$$b4
000265702 7001_ $$aFarvid, Maryam S$$b5
000265702 7001_ $$aHolmes, Michelle D$$b6
000265702 7001_ $$00000-0003-1458-7597$$aWillett, Walter C$$b7
000265702 7001_ $$00000-0002-3961-6609$$aEliassen, A Heather$$b8
000265702 773__ $$0PERI:(DE-600)2975772-1$$a10.1093/jncics/pkac085$$gVol. 7, no. 1, p. pkac085$$n1$$ppkac085$$tJNCI cancer spectrum$$v7$$x2515-5091$$y2023
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