Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis

Neilson, Heather K.; Farris, Megan S.; Stone, Christopher D.; Vaska, Marcus; Brenner, Darren R.; Friedenreich, Christine M.

doi:10.1097/gme.0000000000000745

Cited by 81 publications

(79 citation statements)

References 111 publications

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“…Greater physical activity has been associated with a lower risk of breast cancer. [9–14] While vegetable intake has not been associated with overall breast cancer risk, higher intakes have been associated with a lower risk of estrogen receptor (ER) negative tumors [15, 16], including in a pooled analysis of 20 cohort studies. [17] Longer duration of breastfeeding has also been associated with lower risk of ER− tumors.…”

Section: Introductionmentioning

confidence: 99%

Breast cancer risk prediction: an update to the Rosner–Colditz breast cancer incidence model

Rice

Tworoger

Hankinson

et al. 2017

Breast Cancer Res Treat

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Purpose To update and expand the Rosner-Colditz breast cancer incidence model by evaluating the contributions of more recently identified risk factors as well as predicted percent mammographic density (MD) to breast cancer risk. Methods Using data from the Nurses’ Health Study (NHS) and NHSII, we added adolescent somatotype (9 unit scale), vegetable intake (servings/day), breastfeeding (months), physical activity (MET-hrs/week), and predicted percent MD to the Rosner-Colditz model to determine whether these variables improved model discrimination. We evaluated all invasive as well as ER+/PR+, ER+/PR−, and ER−/PR− breast cancer. Results In the NHS/NHSII, we accrued over 5,200 cases of invasive breast cancer over more than 20 years of follow-up with complete data on the risk factors. Adolescent somatotype and predicted percent MD significantly improved the original Rosner-Colditz model for all invasive breast cancer (change in age-adjusted AUC=0.020, p<0.001). The relative risk (RR) of invasive breast cancer for a 4-unit increase in adolescent somatotype was 0.62 (95%CI: 0.56, 0.70) whereas the RR for a 20-unit increase in predicted percent MD was 1.32 (95%CI: 1.28, 1.36). Adolescent somatotype and predicted percent MD also significantly improved the ER+/PR+ model (change in age-adjusted AUC=0.020, p<0.001) as well as the ER+/PR− model (change in age-adjusted AUC=0.012, p=0.007). Adolescent somatotype, predicted percent MD, breastfeeding, and vegetable intake improved the ER−/PR− model (change in AUC=0.031, p<0.0001). The RR of ER−/PR− disease for 5 vegetable servings/day increase was 0.83 (95%CI: 0.70, 0.99), while the RR for every 12 months of breastfeeding was 0.88 (95%CI: 0.77, 1.01). Physical activity did not improve risk classification in any model. Conclusion Adolescent somatotype and predicted percent MD significantly improved breast cancer risk classification using the Rosner-Colditz model. Further, risk factors specific to ER− disease, such as breastfeeding and vegetable intake, may also help improve risk prediction of this aggressive subtype.

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Section: Introductionmentioning

confidence: 99%

Breast cancer risk prediction: an update to the Rosner–Colditz breast cancer incidence model

Rice

Tworoger

Hankinson

et al. 2017

Breast Cancer Res Treat

View full text Add to dashboard Cite

show abstract

“…In a large meta-analysis of prospective studies, overall, dose-response suggests that the risk of BC decreased by 3% (95% CI: −5 to −2) for every 10 metabolic equivalent of task-hours/week increment in recreational activity (roughly equivalent to 4 h/week of walking at 2 miles/h) 24 . In a more recent meta-analysis including 49 72 . Physical activity at each stage of life from adolescence onward provides a benefit, but sustained activity throughout life may provide the greatest benefit 14 .…”

Section: Physical Activitymentioning

confidence: 99%

The Role of Diet, Physical Activity, Body Fatness, and Breastfeeding in Breast Cancer in Young Women: Epidemiological Evidence

Romieu

Amadou

Chajès

2017

RIC

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The incidence of breast cancer (BC) is rising worldwide, with an increase in aggressive neoplasias in young women. Traditionally, BC in young women has been thought to be etiologically driven, primarily by genetic/hereditary factors. However, these factors explain only a small proportion of BCs, pointing to a role of the environment. Suspected factors responsible for this increase include lifestyle changes, notably alcohol consumption, diet with high intake of refined carbohydrates and saturated fat and low intake of polyunsaturated fatty acids (PUFA), fiber and vitamins (such as folate, vitamin D, and carotenoids), low physical activity, and body fatness, all of which may act from childhood and adolescent years through adulthood. Despite limited data on BC in young women, evidence points to the importance of a healthy lifestyle, including high intake of vegetables, fruits, legumes, fish, and poultry, low intake of sugar and fat, daily physical activity, low alcohol consumption, steady weight, and breastfeeding in preventing BC in young women. Preventive efforts should begin in early life to provide important benefits much later in life by shifting the long-term trajectory of risk accumulation. Data from Latin America and developing regions are still sparse. There is a need to harmonize studies in a global effort to fight the rise of BC incidence in low-and middle-income countries, where the nutritional transition is occurring rapidly. The stratification of BC by specific tumor characteristics needs to be considered since risk factors may be more particularly associated with the promotion of, or protection from, a defined type of BC.

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“…Collectively, the evidence supports an inverse association between physical activity and breast cancer, with a risk reduction of 20-30% when comparing the most physically active to the least active women [21,22] and depending on the study design, population studied, and level of physical activity. The relationship exists for both pre-and postmenopausal women, with greater risk reductions observed among postmenopausal women [7,21]. The magnitude of risk reduction appears to be stronger for strenuous than for moderate levels of exercise [21,23].…”

Section: Physical Activity and Breast Cancer Riskmentioning

confidence: 90%

“…The relationship exists for both pre-and postmenopausal women, with greater risk reductions observed among postmenopausal women [7,21]. The magnitude of risk reduction appears to be stronger for strenuous than for moderate levels of exercise [21,23].…”

Section: Physical Activity and Breast Cancer Riskmentioning

confidence: 99%

Modifiable Lifestyle Factors: Opportunities for (Hereditary) Breast Cancer Prevention - a Narrative Review

Lammert

Grill

Kiechle³

2018

Breast Care

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Increasing rates of obesity, lack of physical activity, sedentary behavior, and frequent alcohol consumption are major lifestyle-related risk factors for breast cancer. In fact, it has been estimated that about one-third of breast cancer cases are attributable to factors women can change. Most research has focused on examining the impact of one single exposure on breast cancer risk while adjusting for other risk modifiers. Capitalizing on big data, major efforts have been made to evaluate the combined impact of well-established lifestyle factors on overall breast cancer risk. At the individual level, data indicate that even simple behavior modifications could have a considerable impact on breast cancer prevention. Moreover, there is emerging new evidence that adopting a healthy lifestyle may be particularly relevant for women with hereditary susceptibility to breast cancer. On the absolute risk scale, studies suggest that the presence of certain risk factors, such as excessive body weight, had a substantially higher impact on breast cancer risk if women had a hereditary predisposition to cancer. The existing body of knowledge gives the medical professionals guidance as to which factors to focus on when counseling patients. However, well-designed randomized controlled trials utilizing objective methods are crucial to providing concrete recommendations.

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Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis

Abstract: Although risk estimates may be similar for premenopausal and postmenopausal breast cancer, subgroup effects may be menopause-dependent.

Cited by 81 publications

References 111 publications

Breast cancer risk prediction: an update to the Rosner–Colditz breast cancer incidence model

Breast cancer risk prediction: an update to the Rosner–Colditz breast cancer incidence model

The Role of Diet, Physical Activity, Body Fatness, and Breastfeeding in Breast Cancer in Young Women: Epidemiological Evidence

Modifiable Lifestyle Factors: Opportunities for (Hereditary) Breast Cancer Prevention - a Narrative Review

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