title: Exercise and Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer.
abstract: Cardiovascular disease (CVD) is a leading cause of death among women with nonmetastatic breast cancer. Whether exercise is associated with reductions in CVD risk in patients with breast cancer with an elevated CVD risk phenotype is not known.
  
  
  
  Using a prospective design, women (n = 2,973; mean age, 57 years) diagnosed with nonmetastatic breast cancer participating in two registry-based, regional cohort studies, completed a questionnaire that assessed leisure-time recreational physical activity (metabolic equivalent task [MET]-h/wk). The primary end point was the first occurrence of any of the following: new diagnosis of coronary artery disease, heart failure, valve abnormality, arrhythmia, stroke, or CVD death, occurring after study enrollment.
  
  
  
  Median follow-up was 8.6 years (range, 0.2 to 14.8 years). In multivariable analysis, the incidence of cardiovascular events decreased across increasing total MET-h/wk categories (Ptrend < .001). Compared with < 2 MET-h/wk, the adjusted hazard ratio was 0.91 (95% CI, 0.76 to 1.09) for 2 to 10.9 MET-h/wk, 0.79 (95% CI, 0.66 to 0.96) for 11 to 24.5 MET-h/wk, and 0.65 (95% CI, 0.53 to 0.80) for ≥ 24.5 MET-h/wk. Similar trends were observed for the incidence of coronary artery disease and heart failure (P values < .05). Adherence to national exercise guidelines for adult patients with cancer (ie, ≥ 9 MET-h/wk) was associated with an adjusted 23% reduction in the risk of cardiovascular events in comparison with not meeting the guidelines (< 9 MET-h/wk; P < .001). The association with exercise did not differ according to age, CVD risk factors, menopausal status, or anticancer treatment.
  
  
  
  Exercise is associated with substantial, graded reductions in the incidence of cardiovascular events in women with nonmetastatic breast cancer.
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX. jonesl3@mskcc.org.
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Habel
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Erin
authors.initials: E
authors.lastname: Weltzien
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Castillo
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Dipti
authors.initials: D
authors.lastname: Gupta
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Candyce H
authors.initials: CH
authors.lastname: Kroenke
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Jessica
authors.initials: J
authors.lastname: Scott
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Anthony
authors.initials: A
authors.lastname: Yu
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
authors.affiliation: Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Caan
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006333:Heart Failure / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D055686:Metabolic Equivalent; D008875:Middle Aged; D011446:Prospective Studies; D065840:Protective Factors; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D011795:Surveys and Questionnaires