Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Cancer Causes & Control
Published in: Cancer Causes & Control 3/2011

Open Access 01-03-2011 | Original paper

Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study

Authors: Lisa A. Cadmus Bertram, Marcia L. Stefanick, Nazmus Saquib, Loki Natarajan, Ruth E. Patterson, Wayne Bardwell, Shirley W. Flatt, Vicky A. Newman, Cheryl L. Rock, Cynthia A. Thomson, John P. Pierce

Published in: Cancer Causes & Control | Issue 3/2011

Login to get access

Abstract

Objective

Research suggests that physical activity is associated with improved breast cancer survival, yet no studies have examined the association between post-diagnosis changes in physical activity and breast cancer outcomes. The aim of this study was to determine whether baseline activity and 1-year change in activity are associated with breast cancer events or mortality.

Methods

A total of 2,361 post-treatment breast cancer survivors (Stage I–III) enrolled in a randomized controlled trial of dietary change completed physical activity measures at baseline and one year. Physical activity variables (total, moderate–vigorous, and adherence to guidelines) were calculated for each time point. Median follow-up was 7.1 years. Outcomes were invasive breast cancer events and all-cause mortality.

Results

Those who were most active at baseline had a 53% lower mortality risk compared to the least active women (HR = 0.47; 95% CI: 0.26, 0.84; p = .01). Adherence to activity guidelines was associated with a 35% lower mortality risk (HR = 0.65, 95% CI: 0.47, 0.91; p < .01). Neither baseline nor 1-year change in activity was associated with additional breast cancer events.

Conclusions

Higher baseline (post-treatment) physical activity was associated with improved survival. However, change in activity over the following year was not associated with outcomes. These data suggest that long-term physical activity levels are important for breast cancer prognosis.
Literature
1.
Thune I, Furberg AS (2001) Physical activity and cancer risk: dose-response and cancer, all sites and site-specific. Med Sci Sports Exerc 33(6 Suppl):S530–S550 discussion S609-10PubMed
2.
Sternfeld B, Lee I-M (2008) Physical activity and cancer: the evidence, the issues, and the challenges. In: Lee I-M (ed) Epidemiologic methods in physical activity studies. Oxford University Press, New York
3.
Bull FC, Armstrong TP, Dixon T, Ham S, Neiman A, Pratt M (2004) Physical inactivity. In: Ezzati M, Lopez AM, Rodgers A, Murray C (eds) Comparative quantification of health risks: global and regional burden of disease attribution to selected major risk factors. World Health Organization, Geneva
4.
Monninkhof EM, Elias SG, Vlems FA et al (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18(1):137–157CrossRefPubMed
5.
Emaus A, Veierod MB, Tretli S et al (2010) Metabolic profile, physical activity, and mortality in breast cancer patients. Breast Cancer Res Treat 121(3):651–660CrossRefPubMed
6.
John EM, Horn-Ross PL, Koo J (2003) Lifetime physical activity and breast cancer risk in a multiethnic population: the San Francisco Bay area breast cancer study. Cancer Epidemiol Biomarkers Prev 12(11 Pt 1):1143–1152PubMed
7.
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. Jama 293(20):2479–2486CrossRefPubMed
8.
Holick CN, Newcomb PA, Trentham-Dietz A et al (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17(2):379–386CrossRefPubMed
9.
Irwin ML, Smith AW, McTiernan A 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(24):3958–3964CrossRefPubMed
10.
Sternfeld B, Weltzien E, Quesenberry CP Jr 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(1):87–95CrossRefPubMed
11.
Friedenreich CM, Gregory J, Kopciuk KA, Mackey JR, Courneya KS (2009) Prospective cohort study of lifetime physical activity and breast cancer survival. Int J Cancer 124(8):1954–1962CrossRefPubMed
12.
Pasanisi P, Berrino F, De Petris M, Venturelli E, Mastroianni A, Panico S (2006) Metabolic syndrome as a prognostic factor for breast cancer recurrences. Int J Cancer 119(1):236–238CrossRefPubMed
13.
Irwin ML, Varma K, Alvarez-Reeves M et al (2009) Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study. Cancer Epidemiol Biomarkers Prev 18(1):306–313CrossRefPubMed
14.
McTiernan A, Ulrich C, Slate S, Potter J (1998) Physical activity and cancer etiology: associations and mechanisms. Cancer Causes Control 9(5):487–509CrossRefPubMed
15.
Pierce JP, Faerber S, Wright FA et al (2002) A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women’s Healthy Eating and Living (WHEL) Study. Control Clin Trials 23(6):728–756CrossRefPubMed
16.
Pierce JP, Natarajan L, Caan BJ et al (2007) Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. Jama 298(3):289–298CrossRefPubMed
17.
Gold EB, Flatt SW, Pierce JP et al (2006) Dietary factors and vasomotor symptoms in breast cancer survivors: the WHEL Study. Menopause 13(3):423–433CrossRefPubMed
18.
Pierce JP, Stefanick ML, Flatt SW et al (2007) Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol 25(17):2345–2351CrossRefPubMed
19.
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(10):1331–1336CrossRefPubMed
20.
Hong S, Bardwell WA, Natarajan L et al (2007) Correlates of physical activity level in breast cancer survivors participating in the Women’s Healthy Eating and Living (WHEL) Study. Breast Cancer Res Treat 101(2):225–232CrossRefPubMed
21.
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(9 Suppl):S498–S504PubMed
22.
Johnson-Kozlow M, Rock CL, Gilpin EA, Hollenbach KA, Pierce JP (2007) Validation of the WHI brief physical activity questionnaire among women diagnosed with breast cancer. Am J Health Behav 31(2):193–202PubMed
23.
Hays RD, Sherbourne CD, Mazel RM (1993) The RAND 36-item health survey 1.0. Health Econ 2(3):217–227CrossRefPubMed
24.
Nelson ME, Rejeski WJ, Blair SN et al (2007) Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39(8):1435–1445CrossRefPubMed
Metadata
Title
Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study
Authors
Lisa A. Cadmus Bertram
Marcia L. Stefanick
Nazmus Saquib
Loki Natarajan
Ruth E. Patterson
Wayne Bardwell
Shirley W. Flatt
Vicky A. Newman
Cheryl L. Rock
Cynthia A. Thomson
John P. Pierce
Publication date
01-03-2011
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 3/2011
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-010-9714-3

Other articles of this Issue 3/2011

Cancer Causes & Control 3/2011 Go to the issue

Review article

A review of African American-white differences in risk factors for cancer: prostate cancer

Brief report

Temporal trends in the black/white breast cancer case ratio for estrogen receptor status: disparities are historically contingent, not innate

Original paper

A Promotora-administered group education intervention to promote breast and cervical cancer screening in a rural community along the U.S.–Mexico border: a randomized controlled trial

Original paper

Reproductive history and risk of three breast cancer subtypes defined by three biomarkers

Original paper

ASIP genetic variants and the number of non-melanoma skin cancers

Original paper

Papillary thyroid cancer incidence rates vary significantly by birthplace in Asian American women
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits