Article Figures & Data
Tables
- Table 1.
Characteristics of LACE cohort at study entry by outcome
Recurrence* Deceased, breast cancer Deceased, all causes No (n = 1,745) Yes (n = 225) P† No (n = 1,868) Yes (n = 102) P† No (n = 1,783) Yes (n = 187) P† Person-years of follow-up 601 9,788 - 345 10,478 - 697 10,125 - Age at enrollment, mean y (SD) 60.6 (10.8) 60.4 (10.9) 0.80 60.4 (10.8) 62.5 (10.7) 0.06 60.0 (10.7) 65.3 (10.5) <0.0001 Race, n (%) 0.93 0.57 0.77 White 1,421 (81.5) 184 (81.8) 1,524 (81.7) 81 (79.4) 1,451 (81.5) 154 (82.4) Other 322 (18.5) 41 (18.2) 342 (18.3) 21(20.6) 330 (18.5) 33 (17.6) Education, n (%) 0.87 0.27 0.0003 High school graduate or less 464 (26.7) 63 (28.0) 494 (26.5) 33 (32.4) 459 (25.8) 68 (36.4) Some college 646 (37.1) 84 (37.3) 691 (37.1) 39 (38.2) 655 (36.8) 75 (40.1) College graduate or more 631 (36.2) 78 (34.7) 679 (36.4) 30 (29.4) 665 (37.4) 44 (23.5) Smoking status, n (%) 0.27 0.38 0.0003 Never 940 (54.2) 112 (49.8) 1,003 (54.0) 49 (48.0) 973 (54.9) 79 (42.3) Past 676 (39.0) 92 (40.9) 725 (39.0) 43 (42.2) 684 (38.6) 84 (44.9) Current 119 (6.8) 21 (9.3) 130 (7.0) 10 (9.8) 116 (6.5) 24 (12.8) BMI at enrollment, mean kg/m2 (SD) 27.4 (5.8) 27.9 (6.1) 0.31 27.4 (5.8) 28.3 (6.1) 0.14 27.3 (5.7) 28.6 (6.5) 0.01 Weight at 18 y, mean lbs (SD) 120.8 (17.0) 123.7 (17.6) 0.02 120.9 (16.9) 125.6 (19.2) 0.02 120.8 (17.0) 123.9 (17.9) 0.03 Menopausal status, n (%) 0.76 0.51 0.0004 Postmenopausal 1,139 (65.3) 142 (63.1) 1,211 (64.8) 70 (68.6) 1,136 (63.7) 145 (77.5) Premenopausal 370 (21.2) 49 (21.8) 402 (21.5) 17 (16.7) 398 (22.3) 21 (11.2) Undetermined 236 (13.5) 34 (15.1) 255 (13.7) 15 (14.7) 249 (14.0) 21 (11.2) Family history of breast cancer, n (%) 0.98 0.96 0.69 No 1,388 (79.6) 179 (79.6) 1,486 (79.6) 81 (79.4) 1,416 (79.5) 151 (80.7) Yes 355 (20.4) 46 (20.4) 380 (20.4) 21 (20.6) 365 (20.5) 36 (19.3) Stage, n (%) <0.0001 <0.0001 <0.0001 I 867 (49.8) 73 (32.6) 915 (49.1) 25 (24.5) 878 (49.3) 62 (33.3) IIa 582 (33.4) 73 (32.6) 623 (33.4) 32 (31.4) 593 (33.3) 62 (33.3) IIb 256 (14.7) 58 (25.9) 282 (15.1) 32 (31.4) 266 (14.9) 48 (25.8) IIIa 37 (2.1) 20 (8.9) 44 (2.4) 13 (12.7) 43 (2.4) 14 (7.5) Type of surgery, n (%) 0.001 0.02 0.01 Conserving 902 (51.7) 91 (40.4) 953 (51.0) 40 (39.2) 915 (51.3) 78 (41.7) Mastectomy 842 (48.3) 134 (59.6) 914 (49.0) 62 (60.8) 867 (48.7) 109 (58.3) Chemotherapy, n (%) <0.0001 0.01 0.62 No 786 (45.4) 70 (31.5) 825 (44.5) 31 (31.3) 773 (43.7) 83 (45.6) Yes 944 (54.6) 152 (68.5) 1,028 (55.5) 68 (68.7) 997 (56.3) 99 (54.4) Radiation therapy, n (%) 0.33 0.06 0.38 No 639 (37.5) 75 (34.1) 686 (37.6) 28 (28.3) 653 (37.4) 61 (34.1) Yes 1,066 (62.5) 145 (65.9) 1,140 (62.4) 71 (71.7) 1,093 (62.6) 118 (65.9) Number of positive nodes, n (%) <0.0001 <0.0001 <0.0001 Node negative 1,097 (66.9) 90 (43.7) 1,154 (66.0) 33 (34.0) 1,105 (66.2) 82 (46.1) 1-3 409 (24.9) 60 (29.1) 435 (24.9) 34 (35.1) 418 (25.1) 51 (28.6) ≥3 134 (8.2) 56 (27.2) 160 (9.1) 30 (30.9) 145 (8.7) 45 (25.3) Tamoxifen use, n (%) 0.31 0.79 0.09 No 389 (22.3) 57 (25.3) 424 (22.7) 22 (21.6) 413 (23.2) 33 (17.6) Yes 1,356 (77.7) 168 (74.7) 1,444 (77.3) 80 (78.4) 1,370 (76.8) 154 (82.4) ER/PR receptor status, n (%) 0.01 0.06 0.03 ER+, PR+ 1,196 (69.4) 131 (59.8) 1,268 (68.8) 59 (59.6) 1,212 (68.9) 115 (62.8) ER+, PR− 239 (13.9) 36 (16.4) 256 (13.9) 19 (19.2) 238 (13.5) 37 (20.2) ER−, PR+ 27 (1.6) 8 (3.7) 31 (1.7) 4 (4.0) 29 (1.7) 6 (3.3) ER−, PR− 260 (15.1) 44 (20.1) 288 (15.6) 17 (17.2) 279 (15.9) 25 (13.7) Time from diagnosis to enrollment, mean y (SD) 1.9 (0.6) 1.9 (0.6) 0.54 1.9 (0.6) 1.9 (0.6) 0.87 1.9 (0.6) 1.9 (0.5) 0.50 Abbreviations: ER+, estrogen receptor positive; ER−, estrogen receptor negative; PR+, progesterone receptor positive; PR−, progesterone receptor negative.
↵* Recurrence includes local, regional, or distant recurrence or metastasis or death from breast cancer if no recurrence was previously reported.
↵† P value for t test for difference in means, or χ2 test for difference in proportions between women with and without the event.
- Table 2.
Level of physical activity in LACE cohort at study entry
Total activity, median MET-h/wk (I-Q range) 44.3 (29.3-62.3) Moderate-vigorous activity, median MET-h/wk (I-Q range) 14.8 (5.3-27.2) Moderate activity, median h/wk(I-Q range) 2.9 (1.0-5.6) Categorized in h/wk, n (%) <1 490 (25%) 1-<3 502 (26%) 3-<6 524 (27%) ≥6 434 (22%) Vigorous activity, median h/wk (I-Q range) 0.0 (0-1.1) Categorized in h/wk, n (%) 0 1,102 (56%) >0-<1 356 (18%) ≥1 505 (26%) Selected activities, median MET-h/wk (I-Q range) 5.9 (0-16.5) Categorized in h/wk, n (%) <9 1,099 (58%) ≥9 804 (42%) - Table 3.
Characteristics of LACE cohort by hours/week of moderate intensity physical activity
Hours per week of moderate activity P* <1 h (n = 490) 1-<3 h (n = 502) 3-<6 h (n = 523) ≥6 h (n = 433) Age at enrollment, mean y (SD) 62.8 (11.1) 60.0 (11.2) 59.9 (10.3) 59.6 (10.2) <0.0001 Race, n (%) 0.15 White 383 (78.2) 409 (81.5) 432 (82.6) 362 (83.6) Other 107 (21.8) 93 (18.5) 91 (17.4) 71 (16.4) Education, n (%) 0.0001 High school graduate or less 167 (34.1) 125 (24.9) 116 (22.2) 116 (26.9) Some college 178 (36.3) 201 (40.0) 198 (37.9) 143 (33.2) College graduate or more 145 (29.6) 176 (35.1) 209 (40.0) 172 (39.9) Smoking status, n (%) 0.40 Never 263 (53.8) 279 (55.8) 269 (51.6) 234 (54.3) Past 184 (37.6) 187 (37.4) 222 (42.6) 165 (38.3) Current 42 (8.6) 34 (6.8) 30 (5.8) 32 (7.4) BMI at enrollment, mean kg/m2 (SD) 28.9 (6.3) 27.9 (5.8) 26.9 (5.6) 26.2 (5.1) <0.0001 Weight at 18 y, mean lbs (SD) 120.5 (17.6) 120.4 (16.2) 122.5 (17.3) 120.6 (16.9) 0.16 Menopausal status, n (%) 0.03 Postmenopausal 340 (69.4) 315 (62.8) 333 (63.5) 286 (65.9) Premenopausal 95 (19.4) 117 (23.3) 100 (19.1) 97 (22.4) Undetermined 55 (11.2) 70 (13.9) 91 (17.4) 51 (11.7) Family history of breast cancer, n (%) 0.74 No 389 (79.4) 408 (81.3) 411 (78.6) 343 (79.2) Yes 101 (20.6) 94 (18.7) 112 (21.4) 90 (20.8) Stage, n (%) 0.21 I 218 (44.7) 233 (46.5) 257 (49.1) 219 (50.6) IIa 163 (33.4) 180 (35.9) 160 (30.5) 147 (34.0) IIb 94 (19.3) 72 (14.4) 90 (17.2) 56 (12.9) IIIa 13 (2.7) 16 (3.2) 17 (3.2) 11 (2.5) Type of surgery, n (%) 0.60 Conserving 244 (49.8) 265 (52.8) 255 (48.7) 218 (50.3) Mastectomy 246 (50.2) 237 (47.2) 269 (51.3) 215 (49.7) Chemotherapy, n (%) 0.03 No 232 (48.2) 195 (39.0) 230 (44.3) 188 (43.5) Yes 249 (51.8) 305 (61.0) 289 (55.7) 244 (56.5) Radiation therapy, n (%) 0.83 No 179 (38.2) 176 (35.6) 197 (37.9) 155 (36.8) Yes 290 (61.8) 319 (64.4) 323 (62.1) 266 (63.2) Number of positive nodes, n (%) 0.06 Node negative 282 (60.6) 291 (62.1) 319 (65.8) 283 (68.9) 1-3 125 (26.9) 121 (25.8) 121 (24.9) 99 (24.1) ≥3 58 (12.5) 57 (12.1) 45 (9.3) 29 (7.1) Tamoxifen use, n (%) .69 No 116 (23.7) 121 (24.1) 113 (21.6) 94 (21.7) Yes 374 (76.3) 381 (75.9) 411 (78.4) 340 (78.3) ER/PR receptor status, n (%) 0.33 ER+, PR+ 330 (68.6) 319 (64.4) 366 (70.8) 296 (69.0) ER+, PR- 62 (12.9) 73 (14.8) 71 (13.7) 67 (15.6) ER-, PR+ 6 (1.2) 12 (2.4) 9 (1.7) 7 (1.6) ER-, PR- 83 (17.3) 91 (18.4) 71 (13.7) 59 (13.8) Time from diagnosis to enrollment, mean y (SD) 1.9 (0.5) 1.9 (0.6) 1.9 (0.6) 1.9 (0.6) 0.91 Follow-up time, mean y (SD) To recurrence 7.0 (1.6) 7.2 (1.6) 7.2 (1.5) 7.2 (1.5) 0.08 To death 7.2 (1.3) 7.4 (1.3) 7.4 (1.2) 7.4 (1.3) 0.08 ↵* ANOVA to test for differences in means of continuous variables; chi-square tests to evaluate differences in proportions for categorical variables.
- Table 4.
Risk of breast cancer recurrence, breast cancer mortality and all-cause mortality associated with physical activity
Recurrence (n = 225) Breast cancer mortality (n = 102) All-cause mortality (n = 187) Model I* Model II† Model I* Model II‡ Model I* Model II§ HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) Total activity, MET-h/wk Q1 (<29) Ref Ref Ref Ref Ref Ref Q2 (29-<44) 0.65 (0.44-0.97) 0.76 (0.51-1.13) 0.83 (0.49-1.40) 1.01 (0.57-1.78) 0.70 (0.47-1.04) 0.89 (0.59-1.33) Q3 (44-<62) 0.82 (0.57-1.19) 0.87 (0.59-1.29) 0.71 (0.41-1.24) 0.70 (0.38-1.29) 0.67 (0.45-1.00) 0.82 (0.54-1.25) Q4 (≥62) 0.79 (0.54-1.15) 0.91 (0.61-1.36) 0.68 (0.39-1.18) 0.87 (0.48-1.59) 0.58 (0.38-0.88) 0.76 (0.48-1.19) P for trend 0.40 0.78 0.14 0.41 0.01 0.20 Moderate-vigorous activity, MET-h/wk Q1 (<5.3) Ref Ref Ref Ref Ref Ref Q2 (5.3-<15) 0.67 (0.46-0.97) 0.73 (0.49-1.09) 0.68 (0.41-1.15) 0.77 (0.44-1.34) 0.63 (0.43-0.93) 0.71 (0.48-1.07) Q3 (15-<27) 0.62 (0.42-0.91) 0.75 (0.50-1.12) 0.47 (0.26-0.85) 0.47 (0.24-0.91) 0.49 (0.32-0.74) 0.58 (0.37-0.90) Q4 (≥27) 0.84 (0.59-1.20) 1.00 (0.68-1.46) 0.68 (0.41-1.15) 0.90 (0.51-1.58) 0.56 (0.38-0.83) 0.74 (0.49-1.13) P for trend 0.31 0.95 0.07 0.38 0.001 0.06 H/wk of moderate activity <1 Ref Ref Ref Ref Ref Ref 1-<3 0.76 (0.53-1.09) 0.81 (0.55-1.18) 0.51 (0.29-0.89) 0.65 (0.36-1.16) 0.59 (0.40-0.87) 0.71 (0.48-1.06) 3-<6 0.80 (0.56-1.13) 0.86 (0.60-1.25) 0.69 (0.42-1.13) 0.69 (0.40-1.19) 0.57 (0.39-0.84) 0.66 (0.44-1.00) ≥6 0.66 (0.44-0.97) 0.81 (0.54-1.22) 0.56 (0.32-0.98) 0.73 (0.40-1.33) 0.51 (0.34-0.79) 0.66 (0.42-1.03) P for trend 0.05 0.36 0.07 0.26 0.001 0.04 Hours/wk of vigorous activity 0 Ref Ref Ref Ref Ref Ref >0-<1 0.88 (0.61-1.28) 0.91 (0.62-1.36) 0.72 (0.40-1.28) 0.79 (0.42-1.48) 0.74 (0.48-1.15) 0.90 (0.57-1.41) ≥1 1.06 (0.78-1.44) 1.12 (0.81-1.56) 0.85 (0.53-1.36) 1.10 (0.68-1.80) 0.87 (0.61-1.23) 1.02 (0.70-1.47) P for trend 0.80 0.58 0.40 0.82 0.33 1.0 Selected activities, MET-h/wk <9 Ref Ref Ref Ref Ref Ref ≥9 1.00 (0.76-1.31) 1.16 (0.87-1.55) 0.91 (0.61-1.36) 1.19 (0.78-1.84) 0.78 (0.57-1.06) 0.98 (0.71-1.35) HR, hazard ratio; 95% CI, 95% confidence interval.
↵* Adjusted for age.
↵† Adjusted for age, number of positive nodes, stage and weight at 18 y.
↵‡ Adjusted for age, number of positive nodes, stage, weight at 18 y, type of treatment (chemotherapy/radiation) and type of surgery (mastectomy or conserving).
↵§ Adjusted for age, number of positive nodes, stage, weight at 18 y, education level and smoking status.
- Table 5.
Multivariable adjusted risk of all-cause mortality associated with moderate intensity physical activity stratified by baseline BMI and ER/PR receptor status
BMI at enrollment, kg/m2 <25 (n = 749) 25-29.9 (n = 656) >30 (n = 518) HR (95% CI) HR (95% CI) HR (95% CI) H/wk of moderate activity <1 Ref Ref Ref 1-<3 0.52 (0.25-1.10) 0.73 (0.37-1.43) 0.84 (0.42-1.70) 3-<6 0.42 (0.20-0.90) 0.74 (0.38-1.45) 0.89 (0.42-1.85) >6 0.38 (0.17-0.85) 0.95 (0.47-1.94) 0.90 (0.38-2.16) P for trend 0.01 0.78 0.76 ER/PR receptor status ER and/or PR negative (n = 614) ER/PR positive (n = 1,327) HR (95% CI) HR (95% CI) H/wk of moderate activity <1 Ref Ref 1-<3 0.80 (0.41-1.54) 0.64 (0.38-1.06) 3-<6 1.06 (0.56-2.00) 0.46 (0.26-0.79) >6 0.75 (0.36-1.59) 0.59 (0.34-1.04) P for trend 0.69 0.01 NOTE: Adjusted for age at enrollment into cohort, number of positive nodes, stage, weight at 18 y, education level and smoking status.