title: Physical activity and breast cancer risk by pathological subtype.
abstract: To examine the influence of physical activity on breast cancer risk and evaluate whether adherence to international recommendations is associated with a decreased risk.
  
  
  
  This is a multicenter matched case-control study where 698 pairs completed a physical activity questionnaire. Recreational physical activity during the last year was quantified in metabolic equivalent hours per week (MET-h/week) and categorized in activities of moderate (3.0-5.9 MET) and vigorous (>6 MET) intensity. The adherence to World Cancer Research Fund and the American Institute for Cancer Research recommendation was also assessed. The association with breast cancer risk, overall and by pathologic subtype, was evaluated using conditional and multinomial logistic regression models.
  
  
  
  Mean MET-h/week was 16.6 among cases and 20.4 among controls. Premenopausal breast cancer risk decreased by 5% (P=0.007) for every 6 MET-h/week increase in energy expenditure. By contrast, postmenopausal women needed to do more intense exercise to observe benefits. The protection was more pronounced for nulliparous women, as well as for hormone receptor positive and HER2+ tumors. Physically inactive women displayed a 71% increased risk when compared with those who met the international recommendation (P=0.001). Finally, women who were inactive during the previous year, regardless of the overall physical activity reported in previous periods, showed an increased risk when compared to always active women.
  
  
  
  Women who report adherence to international physical activity recommendations entail a significant decrease in risk for all pathologic breast cancer subtypes. This is of particular interest in Spain, where a significant increase in overweight and obesity in recent decades is observed.
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Lope
authors.affiliation: Medical Oncology Unit, Hospital Clínico Universitario San Carlos, Madrid, Spain; Health Research Institute Gregorio Marañón, Universidad Complutense, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Martín
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
authors.forename: Adela
authors.initials: A
authors.lastname: Castelló
authors.affiliation: Dpto. Ciencias Sociales de la Actividad Física y del Ocio, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad Politécnica, Madrid, Spain.
authors.forename: Soraya
authors.initials: S
authors.lastname: Casla
authors.affiliation: Medical Oncology Unit, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Ruiz
authors.affiliation: Medical Oncology Unit, Hospital Puerta del Mar, Cádiz, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Baena-Cañada
authors.affiliation: Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: Ana Mª
authors.initials: AM
authors.lastname: Casas
authors.affiliation: Medical Oncology Unit, Complejo Hospitalario Universitario, A Coruña, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Calvo
authors.affiliation: Hematology-Oncology Department, Hospital Clínico Universitario de Valencia/INCLIVA, Universidad de Valencia, Valencia, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Bermejo
authors.affiliation: Medical Oncology Hospital Clínic and Translational Genomics and Targeted Therapeutics in Solid Tumors, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Muñoz
authors.affiliation: Medical Oncology Unit, Centro Oncológico de Galicia, A Coruña, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramos
authors.affiliation: Medical Oncology Unit, Hospital Marqués de Valdecilla, Santander, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: de Juan-Ferré
authors.affiliation: Medical Oncology Unit, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Jara
authors.affiliation: Medical Oncology Unit, Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Antón
authors.affiliation: Spanish Breast Cancer Research Group (GEICAM) Headquarters, Madrid, Spain.
authors.forename: Mª Ángeles
authors.initials: MÁ
authors.lastname: Jimeno
authors.affiliation: Hematology-Oncology Department, Hospital Clínico Universitario de Valencia/INCLIVA, Universidad de Valencia, Valencia, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Lluch
authors.affiliation: Medical Oncology Unit, Complejo Hospitalario Universitario, A Coruña, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Antolín
authors.affiliation: Medical Oncology Unit, Hospital Clínico Universitario San Carlos, Madrid, Spain.
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: García-Sáenz
authors.affiliation: Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: Purificación
authors.initials: P
authors.lastname: Estévez
authors.affiliation: Medical Oncology Unit, Hospital Puerta del Mar, Cádiz, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Arriola-Arellano
authors.affiliation: Medical Oncology Unit, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Gavilá
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.affiliation: Spanish Breast Cancer Research Group (GEICAM) Headquarters, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Carrasco
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain. Electronic address: mpollan@isciii.es.
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Breast cancer; Physical activity; WCRF recommendations