Ethnic and biological differences in the association between physical activity and survival after breast cancer

Abstract

Physical activity is recommended for most cancer patients as a nonpharmacological therapy to improve prognosis. Few studies have investigated the association between physical activity and breast cancer prognosis by ethnicity, biological, and modifiable risk factors for mortality. We investigated the association between physical activity and long-term survival among breast cancer survivors. A total of 397 survivors (96 Hispanic and 301 non-Hispanic White (NHW)) from the New Mexico HEAL study contributed baseline and biological data approximately 6 months after diagnosis. Study outcomes included all-cause, breast cancer-specific, and non-breast cancer mortality. The exposure was self-reported physical activity within the past month. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox Proportional Hazards regression. A total of 133 deaths (53 breast cancer-specific deaths) were observed after a median follow-up time of 13 years. Engaging in >6.9 metabolic equivalent hours/week (MET-h/week) of moderate to vigorous physical activity (active) was inversely associated with all-cause mortality among all women (HR 0.66, 95% CI 0.43–0.99) and NHWs (HR 0.58, 95% CI 0.36–0.94). Active NHW women also had a reduced risk of non-breast cancer mortality (HR 0.56, 95% CI 0.31–0.99), compared to inactive women (0 MET-h/week). In subgroups, we observed the inverse associations with all-cause mortality among women >58 years old (p-interaction= 0.03) and with localized stage (p-interaction = 0.046). Our results confirm the protective association between physical activity and mortality after breast cancer diagnosis, and demonstrate that this association significantly differs by age and cancer stage. Larger studies are warranted to substantiate our findings.

The Benefits of Physical Activity to Reduce Mortality in Postmenopausal Breast Cancer Patients: A Literature Review

“…It shows that the common cause of death in postmenopausal breast cancer patients is not due to breast cancer itself. Other studies show the same result, where the number of death due to other causes than breast cancer is greater than the number of deaths due to breast cancer [36,51,52]. Moreover, the majority of patients in this review reported that there are at least 1 or more preexisting comorbidities conditions at the time of diagnosis.…”

Postdiagnosis recreational physical activity and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

“…The sample size of the identified studies ranged from 103 to 13 302 women. Most (n = 17, 65%) originated from the United States, 11,67,68,70,73,76,77,79‐86,88,93 one (4%) from Mexico, 87 two (8%) from China, 72,78 one (4%) from Germany, 89 one (4%) from Denmark, 69 one (4%) from Norway, 71 one (4%) from Turkey 90 and one (4%) 74 included women from various countries. Most studies reported on recreational physical activity 11,67‐70,72‐79,81‐86 .…”

“…Most studies reported on recreational physical activity 11,67‐70,72‐79,81‐86 . One reported on total physical activity only, 71 one reported total and recreational physical activities, 79 one reported household and recreational physical activities 69 and another one reported results on household physical activity 87 . One study 93 reported on sedentary time (television watching).…”

“…Study selection is shown in Figure 1 . Of 3212 full texts assessed for inclusion, 20 cohort studies 11 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 and three follow‐up analyses of patients enrolled in clinical trials 91 , 92 met our inclusion criteria. Among these, two publications were from the After Breast Cancer Pooling Project (ABCPP).…”

Harnessing Nutrition and Physical Activity for Breast Cancer Prevention and Control to Reduce Racial/Ethnic Cancer Health Disparities

“…The current research climate has resulted in clinical practice guidelines that stem from scientific evidence from predominantly non-Hispanic White study populations. 99,133 The need to include racially/ethnically diverse populations in research and to specifically target minority populations in which disparities are known to exist have never been timelier to achieve health equity.…”