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Association of Physical Activity with Hormone Receptor Status: The Shanghai Breast Cancer Study

¹ The Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics and ² Department of Obstetrics and Gynecology, School of Medicine, University of South Carolina; ³ South Carolina Cancer Center; ⁴ South Carolina Comprehensive Breast Center, Columbia, South Carolina; ⁵ Division of General Internal Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee; ⁶ Cancer Prevention and Control Program, Hollings Cancer Center, Charleston, South Carolina; ⁷ Departments of Medicine and Biostatistics, University of North Carolina, Chapel Hill, North Carolina; and ⁸ Department of Epidemiology, Shanghai Cancer Institute, Shanghai, People's Republic of China

Requests for reprints: Swann Arp Adams, South Carolina Cancer Prevention and Control Program, University of South Carolina, Room 241, 2221 Devine Street, Columbia, SC 29208. Phone: 803-734-4484; Fax: 803-734-5259. E-mail: swann.adams{at}sc.edu

Evidence exists that breast tumors differing by estrogen receptor (ER) and progesterone receptor (PR) status may be phenotypically distinct diseases resulting from dissimilar etiologic processes. Few studies have attempted to examine the association of physical activity with breast cancer subtype. Such research may prove instructive into the biological mechanisms of activity. Consequently, this investigation was designed to assess the relationship between physical activity and hormone receptor-defined breast cancers in a population of Asian women in which the distribution of receptor types differed from traditional Western populations. Participants, ages 25 to 64 years, were recruited into this population-based, case-control study of breast cancer conducted in Shanghai, China from August 1996 to March 1998. Histologically confirmed breast cancer cases with available receptor status information (n = 1001) and age frequency-matched controls (n = 1,556) completed in-person interviews. Polytomous logistic regression was used to model the association between measures of activity with each breast cancer subtype (ER+/PR+, ER–/PR–, ER+/PR–, and ER–/PR+) using the control population as the reference group. Exercise in both adolescence and the last 10 years was associated with a decreased risk of both receptor-positive (ER+/PR+) and receptor-negative (ER–/PR–) breast cancers in both premenopausal and postmenopausal women (odds ratios, 0.44 and 0.51 and 0.43 and 0.21, respectively). Sweating during exercise within the last 10 years was also associated with decreased risk for receptor-positive and receptor-negative breast cancers among postmenopausal women (odds ratios, 0.58 and 0.28, respectively). These findings suggest that physical activity may reduce breast cancer risk through both hormonal and nonhormonal pathways. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1170–8)

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