Division of Chronic Disease Epidemiology, Yale School of Public Health, PO Box 208034, New Haven, CT 06520-8034, USA.
Cancer Prev Res (Phila). 2011 Apr;4(4):522-9. doi: 10.1158/1940-6207.CAPR-10-0295.
Although studies have shown that physically active breast cancer survivors have lower all-cause mortality, the association between change in physical activity from before to after diagnosis and mortality is not clear. We examined associations among pre- and postdiagnosis physical activity, change in pre- to postdiagnosis physical activity, and all-cause and breast cancer-specific mortality in postmenopausal women. A longitudinal study of 4,643 women diagnosed with invasive breast cancer after entry into the Women's Health Initiative study of postmenopausal women. Physical activity from recreation and walking was determined at baseline (prediagnosis) and after diagnosis (assessed at the 3 or 6 years post-baseline visit). Women participating in 9 MET-h/wk or more (∼ 3 h/wk of fast walking) of physical activity before diagnosis had a lower all-cause mortality (HR = 0.61; 95% CI, 0.44-0.87; P = 0.01) compared with inactive women in multivariable adjusted analyses. Women participating in ≥ 9 or more MET-h/wk of physical activity after diagnosis had lower breast cancer mortality (HR = 0.61; 95% CI, 0.35-0.99; P = 0.049) and lower all-cause mortality (HR = 0.54; 95% CI, 0.38-0.79; P < 0.01). Women who increased or maintained physical activity of 9 or more MET-h/wk after diagnosis had lower all-cause mortality (HR = 0.67; 95% CI, 0.46-0.96) even if they were inactive before diagnosis. High levels of physical activity may improve survival in postmenopausal women with breast cancer, even among those reporting low physical activity prior to diagnosis. Women diagnosed with breast cancer should be encouraged to initiate and maintain a program of physical activity.
虽然研究表明，积极锻炼的乳腺癌幸存者全因死亡率较低，但从诊断前到诊断后体力活动的变化与死亡率之间的关系尚不清楚。我们研究了绝经后妇女中诊断前后体力活动、从诊断前到诊断后体力活动的变化与全因死亡率和乳腺癌特异性死亡率之间的关系。这是一项对参加妇女健康倡议研究的绝经后妇女进行的纵向研究，该研究共纳入了 4643 名被诊断患有浸润性乳腺癌的女性。基线时（诊断前）和诊断后（在基线后 3 或 6 年进行评估）测定了来自娱乐和散步的体力活动。与不活跃的女性相比，在诊断前就有 9 MET-h/wk 或更多（约 3 小时/周的快走）体力活动的女性，全因死亡率较低（HR=0.61；95%CI，0.44-0.87；P=0.01）。在多变量调整分析中，诊断后有≥9 MET-h/wk 体力活动的女性，乳腺癌死亡率较低（HR=0.61；95%CI，0.35-0.99；P=0.049），全因死亡率也较低（HR=0.54；95%CI，0.38-0.79；P<0.01）。诊断后增加或维持 9 个或更多 MET-h/wk 体力活动的女性，全因死亡率较低（HR=0.67；95%CI，0.46-0.96），即使她们在诊断前不活跃。高水平的体力活动可能会改善乳腺癌绝经后妇女的生存，即使是那些在诊断前报告体力活动水平低的患者。应鼓励被诊断患有乳腺癌的女性开始并保持体力活动计划。
