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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2010

01-06-2010 | Epidemiology

Metabolic profile, physical activity, and mortality in breast cancer patients

Authors: Aina Emaus, Marit Bragelien Veierød, Steinar Tretli, Sissi Espetvedt Finstad, Randi Selmer, Anne-Sofie Furberg, Leslie Bernstein, Ellen Schlichting, Inger Thune

Published in: Breast Cancer Research and Treatment | Issue 3/2010

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Abstract

Metabolic components [body mass index (BMI), blood pressure, serum lipids] and physical activity may affect biological mechanisms of importance for breast cancer prognosis. A population-based survival study among 1,364 breast cancer cases within the Norwegian Counties Study during 1974–2005 was conducted. Pre-diagnostic measurements of BMI, blood pressure, serum lipids, and self-reported physical activity were assessed. Multivariable Cox proportional hazard models were used in analyses (SAS version 9.11). Among these breast cancer cases (age at diagnosis 27–79 years), 429 women died (8.2 mean follow-up years). Those with a BMI ≥ 30 kg/m2 had a 1.47 higher risk of dying during follow-up than women with a BMI of 18.5–25 kg/m2 [hazard ratio (HR) = 1.47, 95% CI 1.08–1.99]. Women with BMI < 25 kg/m2 and age of diagnosis ≥55 years had a 66% reduction in overall mortality if they regularly exercised before diagnosis compared with sedentary women (HR = 0.34, 95% CI 0.16–0.71). Women in the highest tertile of total cholesterol had a 29% increase in mortality compared to women in the lowest tertile (HR = 1.29, 95% CI 1.01–1.64). Additionally, women in the highest tertile of blood pressure had a 41% increase in mortality compared to women in the lowest tertile of blood pressure (HR = 1.41, 95% CI 1.09–1.83). Our study supports a relationship between mortality not only in relation to BMI, but also blood pressure, lipids, and physical activity among breast cancer patients. These factors may all be important targets for invention among breast cancer patients.
Literature
1.
Abrahamson PE, Gammon MD, Lund MJ, Flagg EW, Porter PL, Stevens J et al (2006) General and abdominal obesity and survival among young women with breast cancer. Cancer Epidemiol Biomarkers Prev 15:1871–1877CrossRefPubMed
2.
Cleveland RJ, Eng SM, Abrahamson PE, Britton JA, Teitelbaum SL, Neugut AI et al (2007) Weight gain prior to diagnosis and survival from breast cancer. Cancer Epidemiol Biomarkers Prev 16:1803–1811CrossRefPubMed
3.
Loi S, Milne RL, Friedlander ML, McCredie MR, Giles GG, Hopper JL et al (2005) Obesity and outcomes in premenopausal and postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev 14:1686–1691CrossRefPubMed
4.
Abrahamson PE, Gammon MD, Lund MJ, Britton JA, Marshall SW, Flagg EW et al (2006) Recreational physical activity and survival among young women with breast cancer. Cancer 107:1777–1785CrossRefPubMed
5.
Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ et al (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386CrossRefPubMed
6.
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486CrossRefPubMed
7.
Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD et al (2008) Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol 26:3958–3964CrossRefPubMed
8.
Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L et al (2007) Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol 25:2345–2351CrossRefPubMed
9.
Sternfeld B, Weltzien E, Quesenberry CP Jr, Castillo AL, Kwan M, Slattery ML et al (2009) Physical activity and risk of recurrence and mortality in breast cancer survivors: findings from the LACE study. Cancer Epidemiol Biomarkers Prev 18:87–95CrossRefPubMed
10.
Ogunleye AA, Holmes MD (2009) Physical activity and breast cancer survival. Breast Cancer Res 11:106CrossRefPubMed
11.
Bahl M, Ennis M, Tannock IF, Hux JE, Pritchard KI, Koo J et al (2005) Serum lipids and outcome of early-stage breast cancer: results of a prospective cohort study. Breast Cancer Res Treat 94:135–144CrossRefPubMed
12.
Braithwaite D, Tammemagi CM, Moore DH, Ozanne EM, Hiatt RA, Belkora J et al (2009) Hypertension is an independent predictor of survival disparity between African-American and white breast cancer patients. Int J Cancer 124:1213–1219CrossRefPubMed
13.
IARC (2002) Weight control and physical activity. International Agency for Research on Cancer, Lyon
14.
Franky Dhaval S, Shilin Nandubhai S, Pankaj Manubhai S, Patel HR, Prabhudas Shankerbhai P (2008) Significance of alterations in plasma lipid profile levels in breast cancer. Integr Cancer Ther 7:33–41CrossRef
15.
Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD et al (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97:1746–1757CrossRefPubMed
16.
Bernstein L, Ross RK (1993) Endogenous hormones and breast cancer risk. Epidemiol Rev 15:48–65PubMed
17.
Furberg AS, Jasienska G, Bjurstam N, Torjesen PA, Emaus A, Lipson SF et al (2005) Metabolic and hormonal profiles: HDL cholesterol as a plausible biomarker of breast cancer risk. The Norwegian EBBA Study. Cancer Epidemiol Biomarkers Prev 14:33–40PubMed
18.
Emaus A, Veierod MB, Furberg AS, Espetvedt S, Friedenreich C, Ellison PT et al (2008) Physical activity, heart rate, metabolic profile, and estradiol in premenopausal women. Med Sci Sports Exerc 40:1022–1030CrossRefPubMed
19.
Wisse BE, Kim F, Schwartz MW (2007) Physiology. An integrative view of obesity. Science 318:928–929CrossRefPubMed
20.
Lu H, Ouyang W, Huang C (2006) Inflammation, a key event in cancer development. Mol Cancer Res 4:221–233CrossRefPubMed
21.
Thune I, Brenn T, Lund E, Gaard M (1997) Physical activity and the risk of breast cancer. N Engl J Med 336:1269–1275CrossRefPubMed
22.
Furberg AS, Veierod MB, Wilsgaard T, Bernstein L, Thune I (2004) Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst 96:1152–1160PubMedCrossRef
23.
Bjartveit K, Foss OP, Gjervig T, Lund-Larsen PG (1979) The cardiovascular disease study in Norwegian counties. Background and organization. Acta Med Scand 634:1–70
24.
Bjartveit K, Foss OP, Gjervig T (1983) The cardiovascular disease study in Norwegian counties. Results from first screening. Acta Med Scand 675:1–184
25.
Gaard M, Tretli S, Loken EB (1995) Dietary fat and the risk of breast cancer: a prospective study of 25,892 Norwegian women. Int J Cancer 63:13–17CrossRefPubMed
26.
Furberg AS, Thune I (2003) Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer 104:669–676CrossRefPubMed
27.
Thelle DS, Forde OH, Arnesen E (1982) Distribution of high-density lipoprotein cholesterol according to age, sex, and ethnic origin: cardiovascular disease study in Finnmark 1977. J Epidemiol Community Health 36:243–247CrossRefPubMed
28.
Thune I, Njolstad I, Lochen ML, Forde OH (1998) Physical activity improves the metabolic risk profiles in men and women: the Tromso Study. Arch Intern Med 158:1633–1640CrossRefPubMed
29.
Ekelund U, Brage S, Franks PW, Hennings S, Emms S, Wareham NJ (2005) Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians: the Medical Research Council Ely Study. Diabetes Care 28:1195–1200CrossRefPubMed
30.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752CrossRefPubMed
31.
Dal Maso L, Zucchetto A, Talamini R, Serraino D, Stocco CF, Vercelli M et al (2008) Effect of obesity and other lifestyle factors on mortality in women with breast cancer. Int J Cancer 123:2188–2194CrossRefPubMed
32.
Goodwin PJ, Boyd NF (1990) Body size and breast cancer prognosis: a critical review of the evidence. Breast Cancer Res Treat 16:205–214CrossRefPubMed
33.
Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23:1370–1378CrossRefPubMed
34.
Demark-Wahnefried W, Rimer BK, Winer EP (1997) Weight gain in women diagnosed with breast cancer. J Am Diet Assoc 97:519–526 529; quiz 527–528CrossRefPubMed
35.
Lopez-Saez JB, Martinez-Rubio JA, Alvarez MM, Carrera CG, Dominguez Villar M, de Lomas Mier AG et al (2008) Metabolic profile of breast cancer in a population of women in southern Spain. Open Clin Cancer J 2:1–6CrossRefPubMed
36.
Vatten LJ, Foss OP, Kvinnsland S (1991) Overall survival of breast cancer patients in relation to preclinically determined total serum cholesterol, body mass index, height and cigarette smoking: a population-based study. Eur J Cancer 27:641–646CrossRefPubMed
37.
Peeters PH, van Noord PA, Hoes AW, Fracheboud J, Gimbrere CH, Grobbee DE (2000) Hypertension and breast cancer risk in a 19-year follow-up study (the DOM cohort). Diagnostic investigation into mammarian cancer. J Hypertens 18:249–254CrossRefPubMed
38.
Eisenmann JC, Welk GJ, Wickel EE, Blair SN (2004) Stability of variables associated with the metabolic syndrome from adolescence to adulthood: the Aerobics Center Longitudinal Study. Am J Hum Biol 16:690–696CrossRefPubMed
39.
Frontini MG, Srinivasan SR, Berenson GS (2003) Longitudinal changes in risk variables underlying metabolic Syndrome X from childhood to young adulthood in female subjects with a history of early menarche: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 27:1398–1404CrossRefPubMed
40.
Ulmer H, Kelleher C, Diem G, Concin H (2003) Long-term tracking of cardiovascular risk factors among men and women in a large population-based health system: the Vorarlberg Health Monitoring & Promotion Programme. Eur Heart J 24:1004–1013CrossRefPubMed
41.
Wilsgaard T, Jacobsen BK, Schirmer H, Thune I, Lochen ML, Njolstad I et al (2001) Tracking of cardiovascular risk factors: the Tromso study, 1979–1995. Am J Epidemiol 154:418–426CrossRefPubMed
42.
Wilsgaard T, Jacobsen BK (2007) Lifestyle factors and incident metabolic syndrome. The Tromso Study 1979–2001. Diabetes Res Clin Pract 78:217–224CrossRefPubMed
43.
Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Madarnas Y et al (2002) Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol 20:42–51CrossRefPubMed
44.
Daling JR, Malone KE, Doody DR, Johnson LG, Gralow JR, Porter PL (2001) Relation of body mass index to tumor markers and survival among young women with invasive ductal breast carcinoma. Cancer 92:720–729CrossRefPubMed
45.
Majed B, Moreau T, Senouci K, Salmon RJ, Fourquet A, Asselain B (2008) Is obesity an independent prognosis factor in woman breast cancer? Breast Cancer Res Treat 111:329–342CrossRefPubMed
Metadata
Title
Metabolic profile, physical activity, and mortality in breast cancer patients
Authors
Aina Emaus
Marit Bragelien Veierød
Steinar Tretli
Sissi Espetvedt Finstad
Randi Selmer
Anne-Sofie Furberg
Leslie Bernstein
Ellen Schlichting
Inger Thune
Publication date
01-06-2010
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2010
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-009-0603-y

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