Association of prediagnostic physical activity with survival following breast cancer diagnosis: influence of TP53 mutation status.
OBJECTIVE
Physical activity both before and after breast cancer diagnosis has been associated with improved survival. However, it is not clear whether this association differs by molecular features of the tumor or by recency of the physical activity to the time of diagnosis.


METHODS
We examined the association of prediagnostic physical activity with survival in a cohort of 1,170 women with primary, incident, and histologically confirmed breast cancer, examining tumor molecular subtypes. Cox regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI).


RESULTS
Mean follow-up time was 87.4 months after breast cancer diagnosis; there were 170 deaths identified. Compared with inactive patients (<3 h/week), women with higher average lifetime physical activity (>6 h/week) had reduced risk of all-cause mortality (adjusted HR = 0.61, 95 % CI 0.40-0.95; p trend =0.04). There were no clear differences in the associations for lifetime and more recent physical activity. Lifetime physical activity was also weakly associated with decreased risk of breast cancer-specific mortality. Higher lifetime physical activity was associated with reduced risk of all-cause mortality among women with ER-positive tumors (HR = 0.52, 95 % CI 0.29-0.93) and mutant TP53 tumors (HR = 0.22, 95 % CI 0.06-0.72); however, no statistically significant interactions were observed for ER or TP53 status.


CONCLUSIONS
Our study further supports that prediagnostic physical activity improves overall survival following breast cancer and suggests that the associations of prediagnostic physical activity with survival following breast cancer may vary by molecular features of the tumor, particularly ER and TP53 status.
Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, Box 1057, New York, NY, 10029, USA, menghua.tao@mssm.edu.
Meng-Hua
MH
Tao
Pierre
P
Hainaut
Catalin
C
Marian
Jing
J
Nie
Christine
C
Ambrosone
Stephen B
SB
Edge
Maurizio
M
Trevisan
Joan
J
Dorn
Peter G
PG
Shields
Jo L
JL
Freudenheim
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D002648:Child; D015331:Cohort Studies; D004273:DNA, Neoplasm / Q000235:genetics; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D009518:New York / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011379:Prognosis; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*; D055815:Young Adult
D004273:DNA, Neoplasm; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53