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

Author:

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

Abstract

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.

Funder

National Heart, Lung, and Blood Institute

National Cancer Institute

Publisher

Springer Science and Business Media LLC

Subject

Obstetrics and Gynecology,Reproductive Medicine,General Medicine

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