Long-term and recent recreational physical activity and survival after breast cancer: the California Teachers Study.
BACKGROUND
Long-term physical activity is associated with lower breast cancer risk. Little information exists on its association with subsequent survival.


METHODS
California Teachers Study cohort members provided information in 1995-1996 on long-term (high school through age 54 years) and recent (past 3 years) participation in moderate and strenuous recreational physical activities. The 3,539 women diagnosed with invasive breast cancer after cohort entry and through December 31, 2004, were followed through December 31, 2005. Of these, 460 women died, 221 from breast cancer. Moderate and strenuous physical activities were combined into low (<or=0.50 h/wk/y of any activity), intermediate (0.51-3.0 h/wk/y of moderate or strenuous activity but no activity >3.0 h/wk/y), or high activity (>3.0 h/wk/y of either activity type). Multivariable relative risks (RR) and 95% confidence intervals (95% CI) for mortality were estimated using Cox proportional hazards methods, adjusting for race/ethnicity, estrogen receptor status, disease stage, and baseline information on comorbidities, body mass index, and caloric intake.


RESULTS
Women with high or intermediate levels of long-term physical activity had lower risk of breast cancer death (RR, 0.53; 95% CI, 0.35-0.80; and RR, 0.65; 95% CI, 0.45-0.93, respectively) than women with low activity levels. These associations were consistent across estrogen receptor status and disease stage, but were confined to overweight women. Deaths due to causes other than breast cancer were related only to recent activity.


CONCLUSIONS
Consistent long-term participation in physical activity before breast cancer diagnosis may lower risk of breast cancer death, providing further justification for public health strategies to increase physical activity throughout the lifespan.
Department of Population Sciences, Division of Cancer Etiology, City of Hope National Medical Center, Duarte, California 91010, USA.
Carmen Nicole
CN
West-Wright
Katherine DeLellis
KD
Henderson
Jane
J
Sullivan-Halley
Giske
G
Ursin
Dennis
D
Deapen
Susan
S
Neuhausen
Peggy
P
Reynolds
Ellen
E
Chang
Huiyan
H
Ma
Leslie
L
Bernstein
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality*; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D015444:Exercise; D005178:Faculty / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013997:Time Factors