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024 7 _ |a 10.1093/jncics/pkac085
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100 1 _ |a Turzanski-Fortner, Renée
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245 _ _ |a Physical activity and breast cancer survival: results from the Nurses' Health Studies.
260 _ _ |a Oxford
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|b Oxford University Press
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520 _ _ |a Physical 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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650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Breast Neoplasms: diagnosis
|2 MeSH
650 _ 2 |a Exercise
|2 MeSH
650 _ 2 |a Proportional Hazards Models
|2 MeSH
650 _ 2 |a Prospective Studies
|2 MeSH
650 _ 2 |a Nurses
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700 1 _ |a Brantley, Kristen D
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700 1 _ |a Tworoger, Shelley S
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700 1 _ |a Tamimi, Rulla M
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700 1 _ |a Rosner, Bernard
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700 1 _ |a Farvid, Maryam S
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700 1 _ |a Holmes, Michelle D
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700 1 _ |a Willett, Walter C
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700 1 _ |a Eliassen, A Heather
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773 _ _ |a 10.1093/jncics/pkac085
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