Abstract：
OBJECTIVE: Studies have reported inverse associations of pre-diagnosis recreational physical activity (RPA) level with all-cause and breast cancer (BCa)-specific mortality among BCa patients. However, the association between pre-diagnosis RPA level and BCa recurrence is unclear. We investigated the association between pre-diagnosis RPA level and risk of BCa recurrence in the California Teachers Study (CTS).
METHODS: Stage I-IIIb BCa survivors (n = 6,479) were followed with median of 7.4 years, and 474 BCa recurrence cases were identified. Long-term (from high school to age at baseline questionnaire, or, age 55 years, whichever was younger) and baseline (past 3 years reported at baseline questionnaire) pre-diagnosis RPA levels were converted to metabolic equivalent of task-hours per week (MET-hrs/wk). Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of BCa recurrence overall and by estrogen receptor (ER)/progesterone receptor (PR) status.
RESULTS: Long-term RPA was not associated with BCa recurrence risk (ptrend = 0.99). The inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was marginally significant (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.79, 95% CI = 0.60-1.03; ptrend = 0.07). However, the association became non-significant after adjusting for post-diagnosis RPA (ptrend = 0.65). An inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was observed in ER-PR- cases (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.31, 95% CI = 0.13-0.72; ptrend = 0.04), but not in ER+ or PR+ cases (ptrend = 0.97).
CONCLUSIONS: Our data indicates that the benefit of baseline RPA on BCa recurrence may differ by tumor characteristics. This information may be particularly important for populations at higher risk of ER-PR- BCa.
METHODS: Stage I-IIIb BCa survivors (n = 6,479) were followed with median of 7.4 years, and 474 BCa recurrence cases were identified. Long-term (from high school to age at baseline questionnaire, or, age 55 years, whichever was younger) and baseline (past 3 years reported at baseline questionnaire) pre-diagnosis RPA levels were converted to metabolic equivalent of task-hours per week (MET-hrs/wk). Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of BCa recurrence overall and by estrogen receptor (ER)/progesterone receptor (PR) status.
RESULTS: Long-term RPA was not associated with BCa recurrence risk (ptrend = 0.99). The inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was marginally significant (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.79, 95% CI = 0.60-1.03; ptrend = 0.07). However, the association became non-significant after adjusting for post-diagnosis RPA (ptrend = 0.65). An inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was observed in ER-PR- cases (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.31, 95% CI = 0.13-0.72; ptrend = 0.04), but not in ER+ or PR+ cases (ptrend = 0.97).
CONCLUSIONS: Our data indicates that the benefit of baseline RPA on BCa recurrence may differ by tumor characteristics. This information may be particularly important for populations at higher risk of ER-PR- BCa.
摘要：
目的：研究报道了诊断前娱乐性体力活动（RPA）水平与BCa患者全因死亡率和乳腺癌（BCa）特异性死亡率呈负相关。然而,诊断前RPA水平与BCa复发之间的关联尚不清楚.我们在加利福尼亚教师研究（CTS）中调查了诊断前RPA水平与BCa复发风险之间的关系。
方法：随访I-IIIb期BCa幸存者（n=6,479），中位数为7.4年，并确定了474例BCa复发病例。长期(从高中到基线问卷的年龄，或者，55岁,以年轻者为准）和基线（基线问卷调查报告的过去3年），将诊断前的RPA水平转换为每周任务小时数的代谢当量（MET-hrs/wk）。多变量Cox比例风险模型估计了BCa总体复发风险和雌激素受体（ER）/孕激素受体（PR）状态的风险比（HR）和95％置信区间（CI）。
结果：长期RPA与BCa复发风险无关（ptrend=0.99）。基线诊断前RPA水平与BCa复发风险之间呈负相关（≥26.0vs.<3.4MET-hrs/wk：HR=0.79，95%CI=0.60-1.03；ptrend=0.07）。然而,校正诊断后RPA后,该关联变得无显著性(ptrend=0.65).在ER-PR-病例中观察到基线诊断前RPA水平与BCa复发风险之间呈负相关（≥26.0vs.<3.4MET-hrs/wk：HR=0.31，95％CI=0.13-0.72；ptrend=0.04），但在ER+或PR+病例中没有(ptrend=0.97)。
结论：我们的数据表明，基线RPA对BCa复发的益处可能因肿瘤特征而异。该信息对于ER-PR-BCa风险较高的人群可能特别重要。
方法：随访I-IIIb期BCa幸存者（n=6,479），中位数为7.4年，并确定了474例BCa复发病例。长期(从高中到基线问卷的年龄，或者，55岁,以年轻者为准）和基线（基线问卷调查报告的过去3年），将诊断前的RPA水平转换为每周任务小时数的代谢当量（MET-hrs/wk）。多变量Cox比例风险模型估计了BCa总体复发风险和雌激素受体（ER）/孕激素受体（PR）状态的风险比（HR）和95％置信区间（CI）。
结果：长期RPA与BCa复发风险无关（ptrend=0.99）。基线诊断前RPA水平与BCa复发风险之间呈负相关（≥26.0vs.<3.4MET-hrs/wk：HR=0.79，95%CI=0.60-1.03；ptrend=0.07）。然而,校正诊断后RPA后,该关联变得无显著性(ptrend=0.65).在ER-PR-病例中观察到基线诊断前RPA水平与BCa复发风险之间呈负相关（≥26.0vs.<3.4MET-hrs/wk：HR=0.31，95％CI=0.13-0.72；ptrend=0.04），但在ER+或PR+病例中没有(ptrend=0.97)。
结论：我们的数据表明，基线RPA对BCa复发的益处可能因肿瘤特征而异。该信息对于ER-PR-BCa风险较高的人群可能特别重要。
