scholarly journals Ethnic and biological differences in the association between physical activity and survival after breast cancer

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yunfeng Cao ◽  
Kathy B. Baumgartner ◽  
Kala Visvanathan ◽  
Stephanie D. Boone ◽  
Richard N. Baumgartner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Mortality ◽  
Breast Cancer Survivors ◽  
Vigorous Physical Activity ◽  
Breast Cancer Mortality ◽  
Biological Data ◽  
Cancer Prognosis ◽  
Term Survival ◽  
All Cause Mortality

Abstract Physical activity is recommended for most cancer patients as a nonpharmacological therapy to improve prognosis. Few studies have investigated the association between physical activity and breast cancer prognosis by ethnicity, biological, and modifiable risk factors for mortality. We investigated the association between physical activity and long-term survival among breast cancer survivors. A total of 397 survivors (96 Hispanic and 301 non-Hispanic White (NHW)) from the New Mexico HEAL study contributed baseline and biological data approximately 6 months after diagnosis. Study outcomes included all-cause, breast cancer-specific, and non-breast cancer mortality. The exposure was self-reported physical activity within the past month. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox Proportional Hazards regression. A total of 133 deaths (53 breast cancer-specific deaths) were observed after a median follow-up time of 13 years. Engaging in >6.9 metabolic equivalent hours/week (MET-h/week) of moderate to vigorous physical activity (active) was inversely associated with all-cause mortality among all women (HR 0.66, 95% CI 0.43–0.99) and NHWs (HR 0.58, 95% CI 0.36–0.94). Active NHW women also had a reduced risk of non-breast cancer mortality (HR 0.56, 95% CI 0.31–0.99), compared to inactive women (0 MET-h/week). In subgroups, we observed the inverse associations with all-cause mortality among women >58 years old (p-interaction= 0.03) and with localized stage (p-interaction = 0.046). Our results confirm the protective association between physical activity and mortality after breast cancer diagnosis, and demonstrate that this association significantly differs by age and cancer stage. Larger studies are warranted to substantiate our findings.

Mammography Surveillance and Mortality in Older Breast Cancer Survivors

2007 ◽  
Vol 25 (21) ◽  
pp. 3001-3006 ◽  
Author(s):  
Timothy L. Lash ◽  
Matthew P. Fox ◽  
Diana S.M. Buist ◽  
Feifei Wei ◽  
Terry S. Field ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Mortality ◽  
Breast Cancer Survivors ◽  
Care Delivery ◽  
Breast Cancer Mortality ◽  
The United States ◽  
Stage I ◽  
Early Stage Disease

Purpose There are more than 2,000,000 breast cancer survivors in the United States today. While surveillance for asymptomatic recurrence and second primary is included in consensus recommendations, the effectiveness of this surveillance has not been well characterized. Our purpose is to estimate the effectiveness of surveillance mammography in a cohort of breast cancer survivors with complete ascertainment of surveillance mammograms and negligible losses to follow-up. Patients and Methods We enrolled 1,846 stage I and II breast cancer patients who were at least 65 years old at six integrated health care delivery systems. We used medical record review and existing databases to ascertain patient, tumor, and therapy characteristics, as well as receipt of surveillance mammograms. We linked personal identifiers to the National Death Index to ascertain date and cause of death. We matched four controls to each breast cancer decedent to estimate the association between receipt of surveillance mammogram and breast cancer mortality. Results One hundred seventy-eight women died of breast cancer during 5 years of follow-up. Each additional surveillance mammogram was associated with a 0.69-fold decrease in the odds of breast cancer mortality (95% CI, 0.52 to 0.92). The protective association was strongest among women with stage I disease, those who received mastectomy, and those in the oldest age group. Conclusion Given existing recommendations for post-therapy surveillance, trials to compare surveillance with no surveillance are unlikely. This large observational study provides support for the recommendations, suggesting that receipt of surveillance mammograms reduces the rate of breast cancer mortality in older patients diagnosed with early-stage disease.

scholarly journals Associations of Insulin Resistance and Adiponectin With Mortality in Women With Breast Cancer

2011 ◽  
Vol 29 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Catherine Duggan ◽  
Melinda L. Irwin ◽  
Liren Xiao ◽  
Katherine D. Henderson ◽  
Ashley Wilder Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Cancer Mortality ◽  
Cancer Survival ◽  
Breast Cancer Mortality ◽  
Breast Cancer Survival ◽  
Overweight And Obesity ◽  
Model Assessment ◽  
All Cause Mortality ◽  
Low Levels

Purpose Overweight or obese breast cancer patients have a worse prognosis compared with normal-weight patients. This may be attributed to hyperinsulinemia and dysregulation of adipokine levels associated with overweight and obesity. Here, we evaluate whether low levels of adiponectin and a greater level of insulin resistance are associated with breast cancer mortality and all-cause mortality. Patients and Methods We measured glucose, insulin, and adiponectin levels in fasting serum samples from 527 women enrolled in the Health, Eating, Activity, and Lifestyle (HEAL) Study, a multiethnic, prospective cohort study of women diagnosed with stage I-IIIA breast cancer. We evaluated the association between adiponectin and insulin and glucose levels (expressed as the Homeostatic Model Assessment [HOMA] score) represented as continuous measures and median split categories, along with breast cancer mortality and all-cause mortality, using Cox proportional hazards models. Results Increasing HOMA scores were associated with reduced breast cancer survival (hazard ratio [HR], 1.12; 95% CI, 1.05 to 1.20) and reduced all-cause survival (HR, 1.09; 95% CI, 1.02 to 1.15) after adjustment for possible confounders. Higher levels of adiponectin (above the median: 15.5 μg/mL) were associated with longer breast cancer survival (HR, 0.39; 95% CI, 0.15 to 0.95) after adjustment for covariates. A continuous measure of adiponectin was not associated with either breast cancer–specific or all-cause mortality. Conclusion Elevated HOMA scores and low levels of adiponectin, both associated with obesity, were associated with increased breast cancer mortality. To the best of our knowledge, this is the first demonstration of the association between low levels of adiponectin and increased breast cancer mortality in breast cancer survivors.

Evaluation of an interactive portal for breast cancer survivors: Use, satisfaction, and preliminary effects.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 200-200
Author(s):  
Wilma Kuijpers ◽  
Wim G Groen ◽  
Hester SA Oldenburg ◽  
Michel W.J.M. Wouters ◽  
Neil K Aaronson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
User Satisfaction ◽  
Breast Cancer Survivors ◽  
Vigorous Physical Activity ◽  
Sf 36 ◽  
Patient Reported

200 Background: MijnAVL is an interactive portal that includes patient education, an overview of appointments, access to the electronic medical record (EMR), patient-reported outcomes plus feedback and physical activity support. The aim of this feasibility study was to evaluate use, satisfaction and preliminary effects among breast cancer survivors. Methods: We included women currently or recently treated for breast cancer with curative intent. At baseline, they completed a questionnaire on sociodemographics, expectations of MijnAVL and three effect measures: patient activation (PAM), quality of life (SF-36), and physical activity (IPAQ). MijnAVL could be used noncommittally for 4 months. Log data were collected retrospectively and participants completed questions on satisfaction and effect measures. This process was conducted twice, to be able to improve MijnAVL iteratively. Results: We included 92 women (mean age 49.5 years, 59% on-treatment). Mean number of logins was 8.7 and mean duration 13.1 minutes. Overview of appointments (80% of participants) and access to the EMR (90%) were most frequently used and most appreciated. Website user satisfaction was rated 3.8 on a 1-5 scale on average and participants were primarily positive about the accessibility of information. We did not find an effect on the PAM. For the SF-36, we found significant improvements on the role functioning – emotional (65.3 to 78.5, p< .01), mental health (69.8 to 76.5, p< .01) and social functioning (71.2 to 80.5, p< .01) domains. Median vigorous physical activity significantly increased from 0 to 360 MET-minutes per week (p< .05); levels of walking and moderate physical activity did not change significantly over time. These effects were not related to the intensity of use of MijnAVL. Conclusions: This study showed that user experiences were positive and that exposure to MijnAVL resulted in improvements on three quality of life domains and vigorous physical activity. More tailored, interactive features might be needed to substantially change empowerment, quality of life and physical activity. Research with a controlled design and possibly a more sensitive measure for patient empowerment are needed to substantiate our findings.

scholarly journals Improving the Physical Activity of Breast Cancer Survivors Through Fitness Trackers

2021 ◽  
Author(s):  
C. Lynch ◽  
S. Bird ◽  
F. Barnett ◽  
N. Lythgo ◽  
I. Selva-Raj
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Controlled Trial ◽  
Vigorous Physical Activity ◽  
Physical Activity Behaviour ◽  
Fitness Tracker ◽  
Fitness Trackers ◽  
Activity Behaviour

Introduction: Increasing physical activity among posttreatment breast cancer survivors is essential, as greater physical activity reduces the relative risk of cancer-specific mortality. This trial examines how a fitness tracker-based intervention changes the physical activity behaviour of inactive posttreatment breast cancer survivors. Methods: Seventeen physically inactive posttreatment breast cancer survivors participated in a randomised cross-over controlled trial. Participants underwent a 12-week intervention of a fitness tracker combined with a behavioural counselling and goal-setting session and 12 weeks of normal activity (control). The primary outcome was the change in physical activity assessed by accelerometry over seven days. Results: The intervention achieved a mean increase of 4.5 min/day of moderate-vigorous physical activity, representative of a small-moderate effect (d = 0.34). Changes in time spent as a proportion of the day in light physical activity (-8.3%) and in sedentary behaviour (7.9%), were both significantly different to baseline (t (16) = 3.522, p < 0.01; t (16) = -3.162, p < 0.01). Conclusion: Interindividual differences in the change of patterns of physical activity behaviour suggest that only for some, fitness trackers can achieve a change in the level of moderate-vigorous physical activity.

Abstract 16348: Comparison of Heart Rate Variability, Physical Activity, and Fitness Parameters Between Healthy Women and Breast Cancer Survivors

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Elena Martínez-Rosales ◽  
Alba Hernández-Martínez ◽  
Manuel Alcaraz-Ibáñez ◽  
Laura López-Sánchez ◽  
David Manuel Díez-Fernández ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Handgrip Strength ◽  
Vigorous Physical Activity ◽  
Low Frequency ◽  
Healthy Women

Introduction: Breast cancer remains the most commonly type of cancer. Heart rate variability (HRV), a clinical indicator of autonomic dysfunction and premature mortality, has been found to be impaired in breast cancer survivors immediately after treatment and in the last stages of metastasis. Physical activity and fitness represent relevant health markers that might prevent some of the side effects following breast cancer treatment, so it would be of clinical interest assessing potential differences with healthy controls. Hypothesis: Compared to healthy women, breast cancer survivors are expected to show impaired HRV-derived parameters, as well as lower physical activity and fitness. Methods: This cross-sectional study included 20 women that survived breast cancer (post-operative period >2 years) and 20 healthy women controls, matched by age and BMI. Fitness evaluations included the modified Ruffier-Dixon test and handgrip strength. Moderate-to-vigorous physical activity (MVPA) was assessed through a self-reported questionnaire. Short-term HRV was measured using 5-minutes recording and were analyzed with Kubios Premium. Sample size was determined for two-tailed tests, statistical power of 0.8, effect size >0.7, and significance level of p<0.05. Between-groups differences were examined using Mann–Whitney U test and Student’s t-test, for normally and not-normally distributed variables, respectively. Results: Concerning HRV parameters, breast cancer survivors presented lower Very Low Frequency and Low Frequency, and higher Low Frequency/High Frequency ratio (all p <0.001), compared to controls. No statistically significant differences were observed in MVPA time ( p =0.48) or estimated VO 2max ( p =0.24), although handgrip strength was decreased in cancer survivors ( p =0.02). Conclusions: A cardiovascular imbalance in breast cancer survivors may be suggested in comparison to healthy age- and BMI-matched controls, as evidenced by reduced HRV after >2 years of post-operative treatment. In contrast, there were no differences in weekly MVPA or VO 2max between groups, although muscular strength could still be affected. These results need to be contrasted by future long-term prospective research.

Meta-Analysis of Breast Cancer Outcomes in Adjuvant Trials of Aromatase Inhibitors Versus Tamoxifen

2010 ◽  
Vol 28 (3) ◽  
pp. 509-518 ◽  
Author(s):  
Mitch Dowsett ◽  
Jack Cuzick ◽  
Jim Ingle ◽  
Alan Coates ◽  
John Forbes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitors ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Hormonal Treatment ◽  
Collaborative Group ◽  
Recurrence Rates ◽  
Term Survival ◽  
Meta Analyses

Purpose To conduct meta-analyses of randomized trials of aromatase inhibitors (AIs) compared with tamoxifen either as initial monotherapy (cohort 1) or after 2 to 3 years of tamoxifen (cohort 2). Materials and Methods Data submitted to the Early Breast Cancer Trialists' Collaborative Group were used in separate meta-analyses of two cohorts. Primary analyses involve postmenopausal women with tumors reported to be estrogen receptor positive. Log-rank P values are two-sided. Results Cohort 1 comprised 9,856 patients with a mean of 5.8 years of follow-up. At 5 years, AI therapy was associated with an absolute 2.9% (SE = 0.7%) decrease in recurrence (9.6% for AI v 12.6% for tamoxifen; 2P < .00001) and a nonsignificant absolute 1.1% (SE = 0.5%) decrease in breast cancer mortality (4.8% for AI v 5.9% for tamoxifen; 2P = .1). Cohort 2 comprised 9,015 patients with a mean of 3.9 years of follow-up. At 3 years from treatment divergence (ie, approximately 5 years after starting hormonal treatment), AI therapy was associated with an absolute 3.1% (SE = 0.6%) decrease in recurrence (5.0% for AI v 8.1% for tamoxifen since divergence; 2P < .00001) and an absolute 0.7% (SE = 0.3%) decrease in breast cancer mortality (1.7% for AI v 2.4% for tamoxifen since divergence; 2P = .02). There was no convincing heterogeneity in the proportional recurrence reduction with respect to age, nodal status, tumor grade, or progesterone receptor status and no indication of an increase in nonbreast deaths with AIs in either cohort. Conclusion AIs produce significantly lower recurrence rates compared with tamoxifen, either as initial monotherapy or after 2 to 3 years of tamoxifen. Additional follow-up will provide clearer information on long-term survival.

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