Abstract

Background

Recreational physical activity (RPA) is associated with improved survival after breast cancer (BC) in average-risk women, but evidence is limited for women who are at increased familial risk because of a BC family history or BRCA1 and BRCA2 pathogenic variants (BRCA1/2 PVs).

Methods

We estimated associations of RPA (self-reported average hours per week within 3 years of BC diagnosis) with all-cause mortality and second BC events (recurrence or new primary) after first invasive BC in women in the Prospective Family Study Cohort (n = 4610, diagnosed 1993-2011, aged 22-79 years at diagnosis). We fitted Cox proportional hazards regression models adjusted for age at diagnosis, demographics, and lifestyle factors. We tested for multiplicative interactions (Wald test statistic for cross-product terms) and additive interactions (relative excess risk due to interaction) by age at diagnosis, body mass index, estrogen receptor status, stage at diagnosis, BRCA1/2 PVs, and familial risk score estimated from multigenerational pedigree data. Statistical tests were 2-sided.

Results

We observed 1212 deaths and 473 second BC events over a median follow-up from study enrollment of 11.0 and 10.5 years, respectively. After adjusting for covariates, RPA (any vs none) was associated with lower all-cause mortality of 16.1% (95% confidence interval [CI] = 2.4% to 27.9%) overall, 11.8% (95% CI = -3.6% to 24.9%) in women without BRCA1/2 PVs, and 47.5% (95% CI = 17.4% to 66.6%) in women with BRCA1/2 PVs (RPA*BRCA1/2 multiplicative interaction P = .005; relative excess risk due to interaction = 0.87, 95% CI = 0.01 to 1.74). RPA was not associated with risk of second BC events.

Conclusion

Findings support that RPA is associated with lower all-cause mortality in women with BC, particularly in women with BRCA1/2 PVs.

Details

Title
Recreational Physical Activity and Outcomes After Breast Cancer in Women at High Familial Risk
Author
Kehm, Rebecca D 1 ; MacInnis, Robert J 2 ; John, Esther M 3 ; Liao, Yuyan 1 ; Kurian, Allison W 4 ; Genkinger, Jeanine M 5 ; Knight, Julia A 6 ; Colonna, Sarah V 7 ; Chung, Wendy K 8 ; Milne, Roger 9 ; Zeinomar, Nur 10 ; Dite, Gillian S 11 ; Southey, Melissa C 12 ; Giles, Graham G 9 ; Sue-Anne McLachlan 13 ; Whitaker, Kristen D 14 ; Friedlander, Michael L 15 ; Weideman, Prue C 11 ; Glendon, Gord 16 ; Nesci, Stephanie 17 ; Kelly-Anne, Phillips 18 ; Andrulis, Irene L 19 ; Buys, Saundra S 20 ; Daly, Mary B 14 ; Hopper, John L 11 ; Terry, Mary Beth 5 

 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA 
 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia 
 Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA 
 Division of Medical Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA 
 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA 
 Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada 
 Division of Medical Oncology, Huntsman Cancer Institute, Salt Lake City, UT, USA 
 Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA; Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY, USA 
 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia 
10  Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA 
11  Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia 
12  Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia 
13  Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia; Department of Medical Oncology, St Vincent’s Hospital, Fitzroy, Melbourne, Victoria, Australia 
14  Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA 
15  Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia 
16  Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada 
17  Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia 
18  Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia 
19  Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Departments of Molecular Genetics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada 
20  Department of Medicine and Huntsman Cancer Institute, University of Utah Health, Salt Lake City, UT, USA 
Publication year
2021
Publication date
Dec 2021
Publisher
Oxford University Press
e-ISSN
25155091
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3170563499
Copyright
© The Author(s) 2021. Published by Oxford University Press. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.