Lin Dan, Thompson Cheryl L, Demalis Alaina, Derbes Rebecca, Al-Shaar Laila, Spielfogel Emma S, Sturgeon Kathleen M
Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA.
Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA.
Cancer Causes Control. 2024 Jul;35(7):1089-1100. doi: 10.1007/s10552-024-01870-8. Epub 2024 Apr 13.
Studies have reported inverse associations of pre-diagnosis recreational physical activity (RPA) level with all-cause and breast cancer (BCa)-specific mortality among BCa patients. However, the association between pre-diagnosis RPA level and BCa recurrence is unclear. We investigated the association between pre-diagnosis RPA level and risk of BCa recurrence in the California Teachers Study (CTS).
Stage I-IIIb BCa survivors (n = 6,479) were followed with median of 7.4 years, and 474 BCa recurrence cases were identified. Long-term (from high school to age at baseline questionnaire, or, age 55 years, whichever was younger) and baseline (past 3 years reported at baseline questionnaire) pre-diagnosis RPA levels were converted to metabolic equivalent of task-hours per week (MET-hrs/wk). Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of BCa recurrence overall and by estrogen receptor (ER)/progesterone receptor (PR) status.
Long-term RPA was not associated with BCa recurrence risk (p = 0.99). The inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was marginally significant (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.79, 95% CI = 0.60-1.03; p = 0.07). However, the association became non-significant after adjusting for post-diagnosis RPA (p = 0.65). An inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was observed in ER-PR- cases (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.31, 95% CI = 0.13-0.72; p = 0.04), but not in ER+ or PR+ cases (p = 0.97).
Our data indicates that the benefit of baseline RPA on BCa recurrence may differ by tumor characteristics. This information may be particularly important for populations at higher risk of ER-PR- BCa.
研究报告称，乳腺癌（BCa）患者诊断前的休闲体育活动（RPA）水平与全因死亡率和BCa特异性死亡率呈负相关。然而，诊断前RPA水平与BCa复发之间的关联尚不清楚。我们在加利福尼亚教师研究（CTS）中调查了诊断前RPA水平与BCa复发风险之间的关联。
对I - IIIb期BCa幸存者（n = 6479）进行了为期7.4年的中位数随访，共确定了474例BCa复发病例。将长期（从高中到基线问卷时的年龄，或55岁，以较小者为准）和基线（基线问卷中报告的过去3年）诊断前RPA水平转换为每周代谢当量任务小时数（MET-hrs/wk）。多变量Cox比例风险模型估计了BCa总体复发风险以及按雌激素受体（ER）/孕激素受体（PR）状态分层的复发风险的风险比（HRs）和95%置信区间（CIs）。
长期RPA与BCa复发风险无关（p = 0.99）。基线诊断前RPA水平与BCa复发风险之间的负相关关系微弱显著（≥26.0 vs. <3.4 MET-hrs/wk：HR = 0.79，95% CI = 0.60 - 1.03；p = 0.07）。然而，在调整诊断后RPA后，这种关联变得不显著（p = 0.65）。在ER-PR-病例中观察到基线诊断前RPA水平与BCa复发风险之间存在负相关（≥26.0 vs. <3.4 MET-hrs/wk：HR = 0.31，95% CI = 0.13 - 0.72；p = 0.04），但在ER+或PR+病例中未观察到（p = 0.97）。
我们的数据表明，基线RPA对BCa复发的益处可能因肿瘤特征而异。这一信息对于ER-PR- BCa风险较高的人群可能尤为重要。
