Physical activity and survival after breast cancer diagnosis
Physical activity and survival after breast cancer diagnosis
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DOI：
10.1001/jama.293.20.2479
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发表时间：
2005-05-25
影响因子：
120.7
通讯作者：
Colditz, GA
中科院分区：
文献类型：
--
作者：
Holmes, MD;Chen, WY;Colditz, GA
背景体力活动已被证明可以降低乳腺癌的发病率，但对乳腺癌诊断后复发或生存的影响尚不清楚。目的确定与久坐的女性相比，乳腺癌女性的体力活动是否可以降低乳腺癌死亡的风险。和参与者前瞻性观察研究的基础上的反应，从2987名女注册护士在护士的健康研究谁被诊断为阶段I，II，1984年至1998年期间患有乳腺癌或III期乳腺癌，并随访至死亡或2002年6月，以先到者为准。主要结果测量根据体力活动类别的乳腺癌死亡风险（=每周24代谢当量任务[MET]小时）。结果与每周从事体力活动少于3 MET小时的女性相比，乳腺癌死亡的校正相对危险度（RR）为0.80（95%置信区间[CI]，0.60-1.06）每周3至8.9个MET小时; 0.50（95% CI，0.31-0.82），每周9 - 14.9 MET小时; 0.56（95% CI，0.38-0.84），每周15 - 23.9 MET小时; 0.60（95% CI，0.40-0.89），每周24小时或以上（趋势P = 0.004）。三个MET小时相当于以2至2.9 mph的平均速度步行1小时。体力活动的益处在患有对肿瘤有反应的肿瘤的女性中尤其明显。每周从事9小时或更多MET活动的乳腺癌反应性肿瘤女性与每周从事不到9小时MET活动的乳腺癌反应性肿瘤女性相比，乳腺癌死亡的RR为0.50（95% CI，0.34-0.74）。与从事每周活动时间少于3个MET小时的女性相比，从事每周9个或更多MET小时的女性在10年时的绝对未经调整的死亡风险降低了6%。结论乳腺癌诊断后的体力活动可能会降低这种疾病的死亡风险。最大的好处发生在那些以平均速度每周步行3到5小时的女性身上，几乎没有证据表明增加的好处和更大的能量消耗之间存在相关性。乳腺癌患者遵循美国的身体活动建议可能会提高他们的生存率。
Context Physical activity has been shown to decrease the incidence of breast cancer, but the effect on recurrence or survival after a breast cancer diagnosis is not known.Objective To determine whether physical activity among women with breast cancer decreases their risk of death from breast cancer compared with more sedentary women.Design, Setting, and Participants Prospective observational study based on responses from 2987 female registered nurses in the Nurses' Health Study who were diagnosed with stage I, II, or III breast cancer between 1984 and 1998 and who were followed up until death or June 2002, whichever came first.Main Outcome Measure Breast cancer mortality risk according to physical activity category (= 24 metabolic equivalenttask [MET] hours per week).Results Compared with women who engaged in less than 3 MET-hours per week of physical activity, the adjusted relative risk (RR) of death from breast cancer was 0.80 (95% confidence interval [CI], 0.60-1.06) for 3 to 8.9 MET-hours per week; 0.50 (95% Cl, 0.31-0.82) for 9 to 14.9 MET-hours per week; 0.56 (95% Cl, 0.38-0.84) for 15 to 23.9 MET-hours per week; and 0.60 (95% Cl, 0.40-0.89) for 24 or more MET-hours per week (P for trend =.004). Three MET-hours is equivalent to walking at average pace of 2 to 2.9 mph for 1 hour. The benefit of physical activity was particularly apparent among women with hormone-responsive tumors. The RR of breast cancer death for women with hormone-responsive tumors who engaged in 9 or more MET-hours per week of activity compared with women with hormone-responsive tumors who engaged in less than 9 MET-hours per week was 0.50 (95% Cl, 0.34-0.74). Compared with women who engaged in less than 3 MET-hours per week of activity, the absolute unadjusted mortality risk reduction was 6% at 10 years for women who engaged in 9 or more MET-hours per week.Conclusions Physical activity after a breast cancer diagnosis may reduce the risk of death from this disease. The greatest benefit occurred in women who performed the equivalent of walking 3 to 5 hours per week at an average pace, with little evidence of a correlation between increased benefit and greater energy expenditure. Women with breast cancer who follow US physical activity recommendations may improve their survival.