Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study.
OBJECTIVE
To investigate the association between pre- and postdiagnosis physical activity (as well as change in prediagnosis to postdiagnosis physical activity) and mortality among women with breast cancer.


METHODS
This was a prospective observational study of 933 women enrolled onto the Health, Eating, Activity, and Lifestyle Study who were diagnosed with local or regional breast cancer between 1995 and 1998 and observed until death or September 2004, whichever came first. The primary outcomes measured were total deaths and breast cancer deaths. The primary exposures were physical activity in the year before and 2 years after diagnosis and the pre- to postdiagnosis change in physical activity.


RESULTS
Compared with inactive women, the multivariable hazard ratios (HRs) for total deaths for women expending at least 9 metabolic equivalent hours per week (approximately 2 to 3 h/wk of brisk walking) were 0.69 (95% CI, 0.45 to 1.06; P = .045) for those active in the year before diagnosis and 0.33 (95% CI, 0.15 to 0.73; P = .046) for those active 2 years after diagnosis. Compared with women who were inactive both before and after diagnosis, women who increased physical activity after diagnosis had a 45% lower risk of death (HR = 0.55; 95% CI, 0.22 to 1.38), and women who decreased physical activity after diagnosis had a four-fold greater risk of death (HR = 3.95; 95% CI, 1.45 to 10.50).


CONCLUSIONS
Moderate-intensity physical activity after a diagnosis of breast cancer may improve prognosis.
Irwin
Melinda L
ML
Department of Epidemiology and Public Health, Yale School of Medicine, P.O. Box 208034, New Haven, CT 06520-8034, USA. melinda.irwin@yale.edu
Smith
Ashley Wilder
AW
McTiernan
Anne
A
Ballard-Barbash
Rachel
R
Cronin
Kathy
K
Gilliland
Frank D
FD
Baumgartner
Richard N
RN
Baumgartner
Kathy B
KB
Bernstein
Leslie
L
D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality*; D015331:Cohort Studies; D004435:Eating; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009043:Motor Activity; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018426:SEER Program; D017741:Survivors