@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 = "Funding Information: This study is funded by the National Heart, Lung, and Blood Institute (contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32 and 44221) for project support, and grant R25CA203650 from the Transdisciplinary Research on Energetics and Cancer Training Workshop for collaborative support (CDC, MI, RC). Funding Information: The authors acknowledge the following investigators in the WHI Program: Program Office: (National Heart, Lung, and Blood Institute, Bethesda, Maryland) Jacques Rossouw, Shari Ludlam, Dale Burwen, Joan McGowan, Leslie Ford, and Nancy Geller. Clinical Coordinating Center: Fred Hutchinson Cancer Research Center, Seattle, WA, Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg. Investigators and Academic Centers: (Brigham and Women's Hospital, Harvard Medical School, Boston, MA) JoAnn E. Manson; (MedStar Health Research Institute/Howard University, Washington, DC) Barbara V. Howard; (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick; (The Ohio State University, Columbus, OH)Rebecca Jackson; (University of Arizona, Tucson/Phoenix, AZ) Cynthia A. Thomson; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Iowa, Iowa City/Davenport, IA) Robert Wallace; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA) Rowan T. Chlebowski; (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker Women{\textquoteright}s Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker. For a list of all the investigators who have contributed to WHI science, please visit: http://www.whi.org/publications/WHI_investigators_longlist.pdf. 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",
}