Modifiable risk factors and survival in women diagnosed with primary breast cancer: results from a prospective cohort study

TY - JOUR

T1 - Modifiable risk factors and survival in women diagnosed with primary breast cancer

T2 - results from a prospective cohort study

AU - Hellmann, Sophie Sell

AU - Thygesen, Lau Caspar

AU - Tolstrup, Janne Schurmann

AU - Grønbaek, Morten

PY - 2010/9

Y1 - 2010/9

N2 - This study examines the impact of smoking, body mass index, alcohol consumption, hormone replacement therapy, and physical activity on all-cause mortality among 528 Danish women diagnosed with primary breast cancer. Participants were women enrolled in the Copenhagen City Heart Study. Prospective self-reported exposure information was collected from four points of follow-up in 1976-1978, 1981-1983, 1991-1994, and 2001-2003. Kaplan-Meier survival curves and multivariate Cox regression analyses were performed adjusting for age, disease stage, adjuvant treatment, menopausal status, parity, alcohol intake, smoking, physical activity, body mass index, and hormone replacement therapy. The study shows that smoking for total mortality [hazard ratio, 1.16; 95% confidence interval, 1.05-1.29] and obesity for both total mortality (1.61; 1.12-2.33) and breast cancer-specific mortality (1.82; 1.11-2.99) were significantly associated with decreased survival after breast cancer diagnosis. A moderate alcohol intake of 1-6 units/week (0.85; 0.64-1.12), 7-14 units/week (0.77; 0.56-1.08), and treatment with hormone replacement therapy (0.79; 0.59-1.05) were less than 1, but not statistically significantly associated with prolonged survival. A moderate physical activity of 2-4 h/week (1.07; 0.77-1.49) and a high physical activity of more than 4 h/week (1.00; 0.69-1.45) showed no association with survival after breast cancer diagnosis.

AB - This study examines the impact of smoking, body mass index, alcohol consumption, hormone replacement therapy, and physical activity on all-cause mortality among 528 Danish women diagnosed with primary breast cancer. Participants were women enrolled in the Copenhagen City Heart Study. Prospective self-reported exposure information was collected from four points of follow-up in 1976-1978, 1981-1983, 1991-1994, and 2001-2003. Kaplan-Meier survival curves and multivariate Cox regression analyses were performed adjusting for age, disease stage, adjuvant treatment, menopausal status, parity, alcohol intake, smoking, physical activity, body mass index, and hormone replacement therapy. The study shows that smoking for total mortality [hazard ratio, 1.16; 95% confidence interval, 1.05-1.29] and obesity for both total mortality (1.61; 1.12-2.33) and breast cancer-specific mortality (1.82; 1.11-2.99) were significantly associated with decreased survival after breast cancer diagnosis. A moderate alcohol intake of 1-6 units/week (0.85; 0.64-1.12), 7-14 units/week (0.77; 0.56-1.08), and treatment with hormone replacement therapy (0.79; 0.59-1.05) were less than 1, but not statistically significantly associated with prolonged survival. A moderate physical activity of 2-4 h/week (1.07; 0.77-1.49) and a high physical activity of more than 4 h/week (1.00; 0.69-1.45) showed no association with survival after breast cancer diagnosis.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Alcohol Drinking

KW - Body Mass Index

KW - Breast Neoplasms

KW - Cause of Death

KW - Denmark

KW - Exercise

KW - Female

KW - Follow-Up Studies

KW - Hormone Replacement Therapy

KW - Humans

KW - Kaplan-Meier Estimate

KW - Middle Aged

KW - Obesity

KW - Prognosis

KW - Prospective Studies

KW - Risk Factors

KW - Smoking

U2 - 10.1097/cej.0b013e32833b4828

DO - 10.1097/cej.0b013e32833b4828

M3 - Journal article

C2 - 20502344

SN - 0959-8278

VL - 19

SP - 366

EP - 373

JO - European Journal of Cancer Prevention

JF - European Journal of Cancer Prevention

IS - 5

ER -