title: The After Breast Cancer Pooling Project: rationale, methodology, and breast cancer survivor characteristics.
abstract: The After Breast Cancer Pooling Project was established to examine the role of physical activity, adiposity, dietary factors, supplement use, and quality of life (QOL) in breast cancer prognosis. This paper presents pooled and harmonized data on post-diagnosis lifestyle factors, clinical prognostic factors, and breast cancer outcomes from four prospective cohorts of breast cancer survivors (three US-based and one from Shanghai, China) for 18,314 invasive breast cancer cases diagnosed between 1976 and 2006. Most participants were diagnosed with stage I-II breast cancer (84.7%). About 60% of breast tumors were estrogen receptor (ER)+/progesterone receptor (PR)+; 21% were ER-/PR-. Among 8,118 participants with information on HER-2 tumor status, 74.8% were HER-2- and 18.5% were HER-2+. At 1-2 years post-diagnosis (on average), 17.9% of participants were obese (BMI ≥ 30 kg/m2), 32.6% were overweight (BMI 25-29 kg/m2), and 59.9% met the 2008 Physical Activity Guidelines for Americans (≥ 2.5 h per week of moderate activity). During follow-up (mean = 8.4 years), 3,736 deaths (2,614 from breast cancer) and 3,564 recurrences have been documented. After accounting for differences in year of diagnosis and timing of post-diagnosis enrollment, five-year overall survival estimates were similar across cohorts. This pooling project of 18,000 breast cancer survivors enables the evaluation of associations of post-diagnosis lifestyle factors, QOL, and breast cancer outcomes with an adequate sample size for investigation of heterogeneity by hormone receptor status and other clinical predictors. The project sets the stage for international collaborations for the investigation of modifiable predictors for breast cancer outcomes.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203-1738, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Nechuta
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Caan
authors.forename: Wendy Y
authors.initials: WY
authors.lastname: Chen
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Patterson
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Poole
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
authors.forename: Zhi
authors.initials: Z
authors.lastname: Chen
authors.forename: Erin
authors.initials: E
authors.lastname: Weltzien
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
authors.forename: Xiao Ou
authors.initials: XO
authors.lastname: Shu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D014481:United States / Q000453:epidemiology; D055815:Young Adult