Physical activity and survival in postmenopausal women with breast cancer: results from the women's health initiative.
Physical activity and survival in postmenopausal women with breast cancer: results from the women's health initiative.
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DOI：
10.1158/1940-6207.capr-10-0295
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发表时间：
2011-04
期刊：
影响因子：
--
通讯作者：
Chlebowski R
中科院分区：
文献类型：
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作者：
Irwin ML;McTiernan A;Manson JE;Thomson CA;Sternfeld B;Stefanick ML;Wactawski-Wende J;Craft L;Lane D;Martin LW;Chlebowski R
尽管研究表明，经常运动的乳腺癌幸存者的全因死亡率较低，但从确诊前到确诊后体力活动的变化与死亡率之间的联系尚不清楚。我们研究了绝经后妇女的诊断前后体力活动、诊断前后体力活动的变化以及全因死亡率和乳腺癌特异性死亡率之间的关系。一项对4643名绝经后妇女参加妇女健康倡议研究后被诊断为浸润性乳腺癌的纵向研究。在基线(诊断前)和诊断后(在基线后的3年或6年的访问中进行评估)确定娱乐和散步的体力活动。在多因素校正分析中，确诊前参加9Met-h/wk或以上体力活动(~3h/wk)的女性全因死亡率(HR=0.61；95%CI，0.44~0.87；P=0.01)低于不运动的女性。确诊后参加≥9 Met-h/wk以上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)，全因死亡率较低(HR=0.54；95%CI，0.38~0.79；P<；0.01)。确诊后体力活动增加或维持在9 Met-h/wk以上的女性，即使在诊断前不活动，全因死亡率也较低(HR=0.67；95%CI，0.46~0.96)。高水平的体力活动可能会提高患有乳腺癌的绝经后女性的存活率，即使是那些在确诊前报告体力活动不足的人。应该鼓励被诊断为乳腺癌的女性开始并保持体力活动计划。
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 post-menopausal 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.