Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women’s Health Initiative

Christina M. Dieli-Conwright; Rebecca A. Nelson; Michael S. Simon; Melinda L. Irwin; Marian L. Neuhouser; Kerryn W. Reding; Tracy E. Crane; Jo Ann E. Manson; Rami Nassir; Aladdin H. Shadyab; Michael LaMonte; Lihing Qi; Cynthia A. Thomson; Candyce H. Kroenke; Kathy Pan; Rowan T. Chlebowski; Joanne Mortimer

doi:10.1186/s12905-022-01614-3

Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women’s Health Initiative

Christina M. Dieli-Conwright, Rebecca A. Nelson, Michael S. Simon, Melinda L. Irwin, Marian L. Neuhouser, Kerryn W. Reding, Tracy E. Crane, Jo Ann E. Manson, Rami Nassir, Aladdin H. Shadyab, Michael LaMonte, Lihing Qi, Cynthia A. Thomson, Candyce H. Kroenke, Kathy Pan, Rowan T. Chlebowski, Joanne Mortimer

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Background: Higher physical activity levels are associated with lower breast cancer-specific mortality. In addition, the metabolic syndrome is associated with higher breast cancer-specific mortality. Whether the physical activity association with breast cancer mortality is modified by number of metabolic syndrome components (cardiometabolic risk factors) in postmenopausal women with early-stage breast cancer remains unknown. Methods: Cardiovascular risk factors included high waist circumference, hypertension, high cholesterol, and diabetes. Breast cancers were verified by medical record review. Mortality finding were enhanced by serial National Death Index queries. Cox proportional hazards regression models were used to estimate associations between baseline physical activity and subsequent breast cancer-specific and overall mortality following breast cancer diagnosis in Women’s Health Initiative participants. These associations were examined after stratifying by cardiometabolic risk factor group. Results: Among 161,308 Women’s Health Initiative (WHI) participants, 8543 breast cancers occurred after 9.5 years (median) follow-up in women, additionally with information on cardiometabolic risk factors and physical activity at entry. In multi-variable analyses, as measured from cancer diagnosis, higher physical activity levels were associated with lower all-cause mortality risk (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.78–0.95, trend P < 0.001) but not with breast cancer-specific mortality (HR 0.85, 95% CI 0.70 to 1.04, trend P = 0.09). The physical activity and all-cause mortality association was not significantly modified by cardiometabolic risk factor number. Conclusions: Among women with early-stage breast cancer, although higher antecedent physical activity was associated with lower risk of all-cause mortality, the association did not differ by cardiometabolic risk factor number.

Original language	English (US)
Article number	32
Journal	BMC Women's Health
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12905-022-01614-3
State	Published - Dec 2022

Keywords

Breast cancer
Metabolic syndrome
Physical activity

ASJC Scopus subject areas

Reproductive Medicine
Obstetrics and Gynecology

Access to Document

10.1186/s12905-022-01614-3

Cite this

Dieli-Conwright, C. M., Nelson, R. A., Simon, M. S., Irwin, M. L., Neuhouser, M. L., Reding, K. W., Crane, T. E., Manson, J. A. E., Nassir, R., Shadyab, A. H., LaMonte, M., Qi, L., Thomson, C. A., Kroenke, C. H., Pan, K., Chlebowski, R. T., & Mortimer, J. (2022). Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women’s Health Initiative. BMC Women's Health, 22(1), Article 32. https://doi.org/10.1186/s12905-022-01614-3

Dieli-Conwright, CM, Nelson, RA, Simon, MS, Irwin, ML, Neuhouser, ML, Reding, KW, Crane, TE, Manson, JAE, Nassir, R, Shadyab, AH, LaMonte, M, Qi, L, Thomson, CA, Kroenke, CH, Pan, K, Chlebowski, RT & Mortimer, J 2022, 'Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women’s Health Initiative', BMC Women's Health, vol. 22, no. 1, 32. https://doi.org/10.1186/s12905-022-01614-3

@article{c93f03f4252a47be8f1c33543a5dc5b1,

title = "Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women{\textquoteright}s Health Initiative",

abstract = "Background: Higher physical activity levels are associated with lower breast cancer-specific mortality. In addition, the metabolic syndrome is associated with higher breast cancer-specific mortality. Whether the physical activity association with breast cancer mortality is modified by number of metabolic syndrome components (cardiometabolic risk factors) in postmenopausal women with early-stage breast cancer remains unknown. Methods: Cardiovascular risk factors included high waist circumference, hypertension, high cholesterol, and diabetes. Breast cancers were verified by medical record review. Mortality finding were enhanced by serial National Death Index queries. Cox proportional hazards regression models were used to estimate associations between baseline physical activity and subsequent breast cancer-specific and overall mortality following breast cancer diagnosis in Women{\textquoteright}s Health Initiative participants. These associations were examined after stratifying by cardiometabolic risk factor group. Results: Among 161,308 Women{\textquoteright}s Health Initiative (WHI) participants, 8543 breast cancers occurred after 9.5 years (median) follow-up in women, additionally with information on cardiometabolic risk factors and physical activity at entry. In multi-variable analyses, as measured from cancer diagnosis, higher physical activity levels were associated with lower all-cause mortality risk (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.78–0.95, trend P < 0.001) but not with breast cancer-specific mortality (HR 0.85, 95% CI 0.70 to 1.04, trend P = 0.09). The physical activity and all-cause mortality association was not significantly modified by cardiometabolic risk factor number. Conclusions: Among women with early-stage breast cancer, although higher antecedent physical activity was associated with lower risk of all-cause mortality, the association did not differ by cardiometabolic risk factor number.",

keywords = "Breast cancer, Metabolic syndrome, Physical activity",

author = "Dieli-Conwright, {Christina M.} and Nelson, {Rebecca A.} and Simon, {Michael S.} and Irwin, {Melinda L.} and Neuhouser, {Marian L.} and Reding, {Kerryn W.} and Crane, {Tracy E.} and Manson, {Jo Ann E.} and Rami Nassir and Shadyab, {Aladdin H.} and Michael LaMonte and Lihing Qi and Thomson, {Cynthia A.} and Kroenke, {Candyce H.} and Kathy Pan and Chlebowski, {Rowan T.} and Joanne Mortimer",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = dec,

doi = "10.1186/s12905-022-01614-3",

language = "English (US)",

volume = "22",

journal = "BMC Women's Health",

issn = "1472-6874",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality

T2 - results from the Women’s Health Initiative

AU - Dieli-Conwright, Christina M.

AU - Nelson, Rebecca A.

AU - Simon, Michael S.

AU - Irwin, Melinda L.

AU - Neuhouser, Marian L.

AU - Reding, Kerryn W.

AU - Crane, Tracy E.

AU - Manson, Jo Ann E.

AU - Nassir, Rami

AU - Shadyab, Aladdin H.

AU - LaMonte, Michael

AU - Qi, Lihing

AU - Thomson, Cynthia A.

AU - Kroenke, Candyce H.

AU - Pan, Kathy

AU - Chlebowski, Rowan T.

AU - Mortimer, Joanne

PY - 2022/12

Y1 - 2022/12

N2 - Background: Higher physical activity levels are associated with lower breast cancer-specific mortality. In addition, the metabolic syndrome is associated with higher breast cancer-specific mortality. Whether the physical activity association with breast cancer mortality is modified by number of metabolic syndrome components (cardiometabolic risk factors) in postmenopausal women with early-stage breast cancer remains unknown. Methods: Cardiovascular risk factors included high waist circumference, hypertension, high cholesterol, and diabetes. Breast cancers were verified by medical record review. Mortality finding were enhanced by serial National Death Index queries. Cox proportional hazards regression models were used to estimate associations between baseline physical activity and subsequent breast cancer-specific and overall mortality following breast cancer diagnosis in Women’s Health Initiative participants. These associations were examined after stratifying by cardiometabolic risk factor group. Results: Among 161,308 Women’s Health Initiative (WHI) participants, 8543 breast cancers occurred after 9.5 years (median) follow-up in women, additionally with information on cardiometabolic risk factors and physical activity at entry. In multi-variable analyses, as measured from cancer diagnosis, higher physical activity levels were associated with lower all-cause mortality risk (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.78–0.95, trend P < 0.001) but not with breast cancer-specific mortality (HR 0.85, 95% CI 0.70 to 1.04, trend P = 0.09). The physical activity and all-cause mortality association was not significantly modified by cardiometabolic risk factor number. Conclusions: Among women with early-stage breast cancer, although higher antecedent physical activity was associated with lower risk of all-cause mortality, the association did not differ by cardiometabolic risk factor number.

AB - Background: Higher physical activity levels are associated with lower breast cancer-specific mortality. In addition, the metabolic syndrome is associated with higher breast cancer-specific mortality. Whether the physical activity association with breast cancer mortality is modified by number of metabolic syndrome components (cardiometabolic risk factors) in postmenopausal women with early-stage breast cancer remains unknown. Methods: Cardiovascular risk factors included high waist circumference, hypertension, high cholesterol, and diabetes. Breast cancers were verified by medical record review. Mortality finding were enhanced by serial National Death Index queries. Cox proportional hazards regression models were used to estimate associations between baseline physical activity and subsequent breast cancer-specific and overall mortality following breast cancer diagnosis in Women’s Health Initiative participants. These associations were examined after stratifying by cardiometabolic risk factor group. Results: Among 161,308 Women’s Health Initiative (WHI) participants, 8543 breast cancers occurred after 9.5 years (median) follow-up in women, additionally with information on cardiometabolic risk factors and physical activity at entry. In multi-variable analyses, as measured from cancer diagnosis, higher physical activity levels were associated with lower all-cause mortality risk (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.78–0.95, trend P < 0.001) but not with breast cancer-specific mortality (HR 0.85, 95% CI 0.70 to 1.04, trend P = 0.09). The physical activity and all-cause mortality association was not significantly modified by cardiometabolic risk factor number. Conclusions: Among women with early-stage breast cancer, although higher antecedent physical activity was associated with lower risk of all-cause mortality, the association did not differ by cardiometabolic risk factor number.

KW - Breast cancer

KW - Metabolic syndrome

KW - Physical activity

UR - http://www.scopus.com/inward/record.url?scp=85124172766&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85124172766&partnerID=8YFLogxK

U2 - 10.1186/s12905-022-01614-3

DO - 10.1186/s12905-022-01614-3

M3 - Article

C2 - 35120497

AN - SCOPUS:85124172766

SN - 1472-6874

VL - 22

JO - BMC Women's Health

JF - BMC Women's Health

IS - 1

M1 - 32

ER -

Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women’s Health Initiative

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this