Exercise and Prognosis on the Basis of Clinicopathologic and Molecular Features in Early-Stage Breast Cancer: The LACE and Pathways Studies. Academic Article uri icon

Overview

abstract

  • To investigate whether the impact of postdiagnosis exercise on breast cancer outcomes in women diagnosed with early-stage breast cancer differs on the basis of tumor clinicopathologic and molecular features. Using a prospective design, 6,211 patients with early-stage breast cancer from two large population-based cohort studies were studied. Age-adjusted and multivariable Cox regression models were performed to determine the relationship between exercise exposure (total MET-hours/week) and recurrence and breast cancer-related death for: (i) all patients ("unselected" cohort), and on the basis of (ii) classic clinicopathologic features, (iii) clinical subtypes, (iv) PAM50-based molecular intrinsic subtypes, and (v) individual PAM50 target genes. After a median follow-up of 7.2 years, in the unselected cohort (n = 6,211) increasing exercise exposure was not associated with a reduction in the risk of recurrence (adjusted Ptrend = 0.60) or breast cancer-related death (adjusted Ptrend = 0.39). On the basis of clinicopathologic features, an exercise-associated reduction in breast cancer-related death was apparent for tumors <2 cm [HR, 0.50; 95% confidence interval (CI), 0.34-0.72], well/moderately differentiated tumors (HR, 0.63; 95% CI, 0.43-0.91), and ER-positive tumors (HR, 0.72; 95% CI, 0.53-0.97). Stratification by clinical subtype indicated that the ER(+)/PR(+)/HER2(-)/low-grade clinical subtype was preferentially responsive to exercise (recurrence: adjusted HR, 0.63; 95% CI, 0.45-0.88; breast cancer-related death: adjusted HR, 0.57; 95% CI, 0.37-0.86). The impact of exercise on cancer outcomes appears to differ as a function of pathologic and molecular features in early-stage breast cancer. Cancer Res; 76(18); 5415-22. ©2016 AACR.

authors

  • Jones, Lee
  • Kwan, Marilyn L
  • Weltzien, Erin
  • Chandarlapaty, Sarat
  • Sternfeld, Barbara
  • Sweeney, Carol
  • Bernard, Philip S
  • Castillo, Adrienne
  • Habel, Laurel A
  • Kroenke, Candyce H
  • Langholz, Bryan M
  • Queensberry, Charles P
  • Dang, Chau T.
  • Weigelt, Britta
  • Kushi, Lawrence H
  • Caan, Bette J

publication date

  • August 3, 2016

Research

keywords

  • Breast Neoplasms
  • Exercise

Identity

PubMed Central ID

  • PMC5026589

Scopus Document Identifier

  • 84988939436

Digital Object Identifier (DOI)

  • 10.1158/0008-5472.CAN-15-3307

PubMed ID

  • 27488523

Additional Document Info

volume

  • 76

issue

  • 18