Physical activity and risk of breast cancer among postmenopausal women.
BACKGROUND
Physical activity has many health benefits. Although greater activity has been related to lower postmenopausal breast cancer risk, important details remain unclear, including type, intensity, and timing of activity and whether the association varies by subgroups.


METHODS
Within the prospective Nurses' Health Study, we assessed the associations of specific and total activity, queried every 2 to 4 years since 1986, with breast cancer risk. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Activity was measured as hours of metabolic equivalent task values (MET-h).


RESULTS
During 20 years of follow-up (1986-2006), 4782 invasive breast cancer cases were documented among 95 396 postmenopausal women. Compared with less than 3 MET-h/wk (<1 h/wk walking), women engaged in higher amounts of recent total physical activity were at lower breast cancer risk (≥27 MET-h/wk [approximately 1 h/d of brisk walking]: HR, 0.85; 95% CI, 0.78-0.93; P < .001 for trend). Compared with women who were least active at menopause and through follow-up (<9 MET-h/wk [approximately 30 minutes of walking at an average pace on most days of the week]), women who increased activity were at lower risk (<9 MET-h/wk at menopause and ≥9 MET-h/wk during follow-up: HR, 0.90; 95% CI, 0.82-0.98). Among specific activities modeled simultaneously, brisk walking was associated with lower risk (per 20 MET-h/wk [5 h/wk]: HR, 0.91; 95% CI, 0.84-0.98). The association with total activity did not differ significantly between estrogen and progesterone receptor-positive and -negative tumors (P = .65 for heterogeneity).


CONCLUSIONS
Our findings suggest that moderate physical activity, including brisk walking, may reduce postmenopausal breast cancer risk and that increases in activity after menopause may be beneficial.
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. heather.eliassen@channing.harvard.edu
A Heather
AH
Eliassen
Susan E
SE
Hankinson
Bernard
B
Rosner
Michelle D
MD
Holmes
Walter C
WC
Willett
D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D016001:Confidence Intervals; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology