Department of Oncology, Oslo University Hospital, Oslo, Norway.
Faculty of Health Services, Institute of Community Medicine, University of Tromsø, Tromsø, Norway.
Breast Cancer Res Treat. 2020 Jul;182(1):215-227. doi: 10.1007/s10549-020-05679-2. Epub 2020 May 20.
Whether an unfavorable lifestyle not only affects breast cancer risk, but also influences age at onset of breast cancer and survival, is under debate.
In a population-based cohort, the Energy Balance and Breast Cancer Aspects throughout life (EBBA-Life) study, a total of 17,145 women were included. During follow-up, 574 women developed invasive breast cancer. Breast cancer cases were followed for an additional 9.1 years. Detailed medical records were obtained. Cox's proportional hazard regression models were used to study the association between pre-diagnostic lifestyle factors (weight, physical activity, alcohol use, smoking, and hypertension), breast cancer risk, age at diagnosis, and survival.
At study entry, 34.3% of the participating women were overweight and 30.7% were physically inactive. Mean age at breast cancer diagnosis was 58.0 years, and 78.9% of the tumors were estrogen receptor positive. Among menopausal women who did not use hormone therapy and had an unfavorable lifestyle (3-5 unfavorable factors), compared with women who had a favorable lifestyle, we observed a twofold higher risk for postmenopausal breast cancer (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.23-3.69), and they were 3.4 years younger at diagnosis (64.8 versus 68.2 years, P = 0.032). Breast cancer patients with an unfavorable lifestyle, compared with patients with a favorable lifestyle, had almost a two times higher overall mortality risk (HR 1.96, 95% CI 1.01-3.80).
Our study supports a healthy lifestyle improving breast cancer prevention, postponing onset of disease, and extending life expectancy among breast cancer patients.
不良的生活方式不仅会影响乳腺癌的发病风险，还会影响乳腺癌的发病年龄和生存，这一点存在争议。
在一项基于人群的队列研究——能量平衡与乳腺癌终生（EBBA-Life）研究中，共纳入了 17145 名女性。在随访期间，有 574 名女性发生浸润性乳腺癌。对乳腺癌病例进行了额外 9.1 年的随访。获取了详细的医疗记录。使用 Cox 比例风险回归模型研究了预诊断生活方式因素（体重、体力活动、饮酒、吸烟和高血压）与乳腺癌风险、诊断时年龄和生存之间的关系。
在研究开始时，34.3%的参与女性超重，30.7%的女性不活跃。乳腺癌诊断的平均年龄为 58.0 岁，78.9%的肿瘤为雌激素受体阳性。对于未使用激素治疗且生活方式不佳（3-5 个不利因素）的绝经后女性，与生活方式良好的女性相比，我们观察到绝经后乳腺癌的风险增加了两倍（风险比 [HR] 2.13，95%置信区间 [CI] 1.23-3.69），且诊断时年轻了 3.4 岁（64.8 岁比 68.2 岁，P=0.032）。与生活方式良好的乳腺癌患者相比，生活方式不佳的乳腺癌患者总死亡率风险几乎高出两倍（HR 1.96，95%CI 1.01-3.80）。
本研究支持健康的生活方式可以提高乳腺癌的预防效果，推迟疾病的发病，并延长乳腺癌患者的预期寿命。
