TY - JOUR
T1 - Exercise after diagnosis of breast cancer in association with survival
AU - Chen, Xiaoli
AU - Lu, Wei
AU - Zheng, Wei
AU - Gu, Kai
AU - Matthews, Charles E.
AU - Chen, Zhi
AU - Zheng, Ying
AU - Shu, Xiao Ou
PY - 2011/9
Y1 - 2011/9
N2 - It has been suggested that exercise following breast cancer diagnosis is inversely associated with mortality. However, controversy exists regarding the causality of such associations. We evaluated associations of exercise after breast cancer diagnosis with total mortality and recurrence/disease-specific mortality, accounting for conditions that restrict exercise participation. The analysis included 4,826 women with stage I to III breast cancer identified 6 months after diagnosis through the population-based Shanghai Cancer Registry and recruited into the study between 2002 and 2006. Exercise was assessed approximately 6, 18, and 36 months postdiagnosis, and metabolic equivalent (MET) scores were derived. Information on medical history, cancer diagnosis, treatments, quality of life (QOL), anthropometrics, and lifestyles were obtained by in-person interviews at 6 months postdiagnosis. Medical charts were abstracted to verify clinical information. During the median follow-up of 4.3 years, 436 deaths and 450 recurrences/cancerrelated deaths were documented. After adjustment for QOL, clinical prognostic factors, and other covariates, exercise during the first 36 months postdiagnosis was inversely associated with total mortality and recurrence/disease-specific mortality with HRs of 0.70 (95% CI: 0.56-0.88) and 0.60 (95% CI: 0.47-0.76), respectively. Significant dose-response relationships between total and recurrence/diseasespecific mortality rates and exercise duration and MET scores were observed (all values for P trend < 0.05). The exercise-mortality associations were not modified by menopausal status, comorbidity, QOL, or body size assessed at approximately 6 months postdiagnosis. An interaction between disease stage and hormone receptor status and total mortality was noted. Our study suggests that exercise after breast cancer diagnosis may improve overall and disease-free survival.
AB - It has been suggested that exercise following breast cancer diagnosis is inversely associated with mortality. However, controversy exists regarding the causality of such associations. We evaluated associations of exercise after breast cancer diagnosis with total mortality and recurrence/disease-specific mortality, accounting for conditions that restrict exercise participation. The analysis included 4,826 women with stage I to III breast cancer identified 6 months after diagnosis through the population-based Shanghai Cancer Registry and recruited into the study between 2002 and 2006. Exercise was assessed approximately 6, 18, and 36 months postdiagnosis, and metabolic equivalent (MET) scores were derived. Information on medical history, cancer diagnosis, treatments, quality of life (QOL), anthropometrics, and lifestyles were obtained by in-person interviews at 6 months postdiagnosis. Medical charts were abstracted to verify clinical information. During the median follow-up of 4.3 years, 436 deaths and 450 recurrences/cancerrelated deaths were documented. After adjustment for QOL, clinical prognostic factors, and other covariates, exercise during the first 36 months postdiagnosis was inversely associated with total mortality and recurrence/disease-specific mortality with HRs of 0.70 (95% CI: 0.56-0.88) and 0.60 (95% CI: 0.47-0.76), respectively. Significant dose-response relationships between total and recurrence/diseasespecific mortality rates and exercise duration and MET scores were observed (all values for P trend < 0.05). The exercise-mortality associations were not modified by menopausal status, comorbidity, QOL, or body size assessed at approximately 6 months postdiagnosis. An interaction between disease stage and hormone receptor status and total mortality was noted. Our study suggests that exercise after breast cancer diagnosis may improve overall and disease-free survival.
UR - http://www.scopus.com/inward/record.url?scp=80052567826&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052567826&partnerID=8YFLogxK
U2 - 10.1158/1940-6207.CAPR-10-0355
DO - 10.1158/1940-6207.CAPR-10-0355
M3 - Article
C2 - 21795422
AN - SCOPUS:80052567826
SN - 1940-6207
VL - 4
SP - 1409
EP - 1418
JO - Cancer Prevention Research
JF - Cancer Prevention Research
IS - 9
ER -