Recreational physical activity and breast cancer risk by menopausal status and tumor hormone receptor status: results from the Nurses' Health Studies

Renée T Fortner; Kristen D Brantley; Shelley S Tworoger; Rulla M Tamimi; Bernard Rosner; Michelle D Holmes; Walter C Willett; A Heather Eliassen

doi:10.1007/s10549-023-07238-x

Recreational physical activity and breast cancer risk by menopausal status and tumor hormone receptor status: results from the Nurses' Health Studies

Breast Cancer Res Treat. 2024 Apr 9. doi: 10.1007/s10549-023-07238-x. Online ahead of print.

Authors

Renée T Fortner^{1

2}, Kristen D Brantley^{3

4}, Shelley S Tworoger⁵, Rulla M Tamimi^{4

6}, Bernard Rosner^{3

4

7}, Michelle D Holmes^{3

4}, Walter C Willett^{3

4

8}, A Heather Eliassen^{3

4}

Affiliations

¹ Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Majorstuen, Postbox 5313, 0304, Oslo, Norway. Renee.Turzanski.Fortner@kreftregisteret.no.
² Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. Renee.Turzanski.Fortner@kreftregisteret.no.
³ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁴ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁵ Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
⁶ Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
⁷ Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁸ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

PMID: 38592542
DOI: 10.1007/s10549-023-07238-x

Abstract

Purpose: Physical activity is associated with lower breast cancer risk, especially in postmenopausal women. Associations in premenopausal women are less well established.

Methods: We evaluated recreational physical activity and breast cancer risk in the Nurses' Health Study (NHS) and NHSII (187,278 women; n = 12,785 breast cancers; follow-up: NHS = 1986-2016, NHSII = 1989-2017) by menopausal status and estrogen (ER) and progesterone (PR) receptor status. Physical activity was evaluated as updated cumulative average of metabolic equivalent of task (MET)-h/week. Cox proportional hazards models were used to estimate multivariable hazard ratios (HR) and 95% confidence intervals (CI).

Results: Recreational physical activity was inversely associated with breast cancer risk in pre- and postmenopausal women. Higher activity levels were associated with lower risk of ER+/PR + breast cancer in both pre- and postmenopausal women (e.g., total recreational activity, ≥ 27 vs < 3 MET-h/week, premenopausal HR = 0.83, 95%CI = (0.70-0.99), postmenopausal HR = 0.86 (0.78-0.95); p_{heterogeneity} = 0.97). Results were attenuated with adjustment for current body mass index (BMI) among postmenopausal, but not premenopausal, women (e.g., ≥ 27 vs < 3 MET-h/week, premenopausal HR = 0.83 (0.69-0.98); postmenopausal HR = 0.95 (0.85-1.05); p_{heterogeneity} = 0.99). In analyses of moderate-vigorous activity and breast cancer risk, no heterogeneity by menopausal status was observed (p_het ≥ 0.53; e.g., ≥ 27 vs < 3 MET-h/week, ER+/PR+, premenopausal HR = 0.88 (0.69-1.11); postmenopausal HR = 0.71 (0.58-0.88). No associations were observed for ER-/PR- disease.

Conclusions: Recreational physical activity was associated with lower breast cancer risk in both pre- and postmenopausal women, supporting recreational physical activity as an accessible, modifiable exposure associated with reduced breast cancer risk regardless of menopausal status.

Keywords: Breast cancer; Hormone receptor status; Menopausal status; Physical activity; Risk.

Abstract

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