Article Figures & Data
Figures
- Figure 1.
Overall survival curves among Chinese women diagnosed with breast cancer by regular exercise participation during the first 6 months after breast cancer diagnosis (n = 4,826).
- Figure 2.
Disease-free survival curves among Chinese women diagnosed with breast cancer by regular exercise participation during the first 6 months after breast cancer diagnosis (n = 4,511).
Tables
- Table 1.
Sociodemographic and clinical characteristics of breast cancer cases at study enrollment
Characteristic Total (n = 4,826)a Exercisers (n = 3,115)a Nonexercisers (n = 1,711)a Pb Age at diagnosis, y 53.5 (10.0) 53.4 (10.0) 53.6 (10.1) 0.452 Education, % <High school 46.5 45.0 49.2 0.003 High school 37.6 38.0 37.0 >High school 15.9 17.1 13.8 Income (yuan/mo/capita), % <1,000 57.7 56.5 59.9 0.008 1,000–1,999 30.4 30.6 30.0 ≥2,000 11.9 12.9 10.1 Married/living with partner, % 88.0 88.1 87.8 0.801 Interval from diagnosis to study enrollment, mo 6.5 (0.7) 6.5 (0.7) 6.5 (0.8) 0.755 Charlson comorbidity index ≥1 19.8 19.5 20.5 0.377 TNM stage, % I 34.8 36.4 31.9 <0.001c IIa 33.9 34.0 33.8 IIb 17.2 16.5 18.4 III 9.4 8.4 11.2 Unknown 4.7 4.7 4.9 ER/PR status, % Positive (ER+/PR+) 50.3 50.2 50.3 0.651c Negative (ER−/PR−) 27.4 27.1 27.9 Mixed (ER+/PR− or ER−/PR+) 20.4 20.8 19.8 Unknown 1.9 1.8 2.0 Ever received chemotherapy, % 92.2 91.2 94.0 <0.001 Ever received radiotherapy, % 32.4 29.6 37.5 <0.001 Ever received immunotherapy, % 14.8 15.1 14.4 0.580 Ever used tamoxifen, % 51.9 54.3 48.0 <0.001 Type of surgery, % Mastectomy 94.1 94.7 93.8 0.352 Conservation 2.6 2.5 2.8 Others 3.0 2.8 3.3 Family history of breast cancer, % 5.6 5.5 5.7 0.695 BMI, kg/m2 24.1 (3.4) 24.1 (3.3) 24.2 (3.6) 0.174 Waist-to-hip ratio 0.83 (0.05) 0.83 (0.05) 0.84 (0.06) <0.001 Cigarette smoking, % 2.6 2.2 3.3 0.020 Alcohol consumption, % 3.1 2.9 3.5 0.271 Tea consumption, % 23.6 25.3 20.5 <0.001 Postmenopausal, % 51.1 51.1 51.2 0.935 Meat intake, g/d 82.7 (57.8) 83.6 (56.8) 81.1 (59.0) 0.148 Cruciferous vegetable intake, g/d 74.6 (53.0) 78.3 (52.1) 68.0 (54.0) <0.001 Soy protein intake, g/d 11.4 (8.6) 12.0 (8.8) 10.1 (8.0) <0.001 QOL score 58.1 (14.2) 59.3 (13.6) 55.9 (14.9) <0.001 -
aUnless otherwise specified, means (SD) are presented.
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bFor tests of differences between women with and without exercise participation.
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cFor the χ2 test, “unknown” group was excluded.
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- Table 2.
Associations of exercise after breast cancer diagnosis with total mortality and relapse/disease-specific mortality
HR (95% CI) Characteristics Total Events First 6 mo postdiagnosisa First 18 mo postdiagnosisb First 36 mo postdiagnosisb Total mortality 4,826 436 Exercise participation No 1,711 185 1.00 1.00 1.00 Yes 3,115 251 0.80 (0.65–0.97) 0.70 (0.56–0.87) 0.70 (0.56–0.88) Exercise participation per week, h No exercise 1,711 185 1.00 1.00 1.00 <2.5 1,654 126 0.78 (0.62–0.98) 0.75 (0.59–0.96) 0.84 (0.66–1.08) ≥2.5 1,461 125 0.82 (0.64–1.04) 0.66 (0.51–0.84) 0.64 (0.49–0.82) Ptrend 0.168 0.004 0.002 Exercise energy expenditure, MET-hours per week No exercise 1,711 185 1.00 1.00 1.00 <8.3 1,566 122 0.79 (0.63–0.99) 0.77 (0.60–0.99) 0.81 (0.63–1.05) ≥8.3 1,549 129 0.80 (0.63–1.02) 0.65 (0.51–0.83) 0.65 (0.51–0.84) Ptrend 0.198 0.004 <0.001 Relapse/disease-specific mortality 4,511 450 Exercise participation No 1,580 174 1.00 1.00 1.00 Yes 2,931 276 0.91 (0.75–1.11) 0.71 (0.57–0.90) 0.60 (0.47–0.76) Exercise participation per week, h No exercise 1,580 174 1.00 1.00 1.00 <2.5 1,552 133 0.84 (0.66–1.05) 0.70 (0.54–0.90) 0.63 (0.48–0.82) ≥2.5 1,379 143 1.01 (0.80–1.27) 0.73 (0.57–0.94) 0.57 (0.44–0.74) Ptrend 0.522 0.341 0.030 Exercise energy expenditure, MET-hours per week No exercise 1,580 174 1.00 1.00 1.00 <8.3 1,468 128 0.85 (0.67–1.07) 0.70 (0.54–0.91) 0.60 (0.46–0.78) ≥8.3 1,463 148 0.98 (0.78–1.24) 0.72 (0.57–0.93) 0.59 (0.45–0.76) Ptrend 0.471 0.324 0.006 -
aAdjusted for date of birth, BMI at baseline, waist-to-hip ratio at baseline, menopausal status, income, education, QOL, cruciferous vegetable intake, soy protein intake, tea consumption, chemotherapy, radiotherapy, tamoxifen use, TNM status, and ER/PR status.
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bAdjusted for the same variables as above, but exercise was treated as a time-dependent variable.
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- Table 3.
Associations of exercise over the first 36 months after breast cancer diagnosis with total mortality and relapse/disease-specific mortality, stratified by disease stage and hormone receptor status
Total mortality Relapse/disease-specific mortality Total Events HR (95% CI) Total Events HR (95% CI) Stratified by TNM a TNM I–IIa stage 3,316 166 3,124 190 MET-hours per weekb No exercise 1,123 67 1.00 1,044 69 1.00 <8.3 1,097 44 0.79 (0.51–1.22) 1,032 50 0.52 (0.32–0.80) ≥8.3 1,096 55 0.89 (0.59–1.36) 1,048 71 0.62 (0.41–0.92) Ptrend 0.333 0.444 TNM IIb–III stage 1,282 249 1,176 241 MET-hours per weekb No exercise 505 110 1.00 461 102 1.00 <8.3 395 73 0.83 (0.60–1.15) 364 71 0.57 (0.40–0.82) ≥8.3 382 66 0.52 (0.37–0.72) 351 68 0.45 (0.32–0.64) Ptrend <0.001 <0.002 Pinteraction 0.037 0.218 Stratified by ER/PR c ER+PR+ (positive) 2,426 161 2,308 189 MET-hours per weekb No exercise 861 70 1.00 815 80 1.00 <8.3 809 39 1.41 (0.87–2.27) 771 46 0.72 (0.47–1.12) ≥8.3 756 52 1.32 (0.83–2.12) 722 63 0.79 (0.53–1.19) Ptrend 0.935 0.540 ER−PR− (negative) 1,323 171 1,213 155 MET-hours per weekb No exercise 478 76 1.00 428 62 1.00 <8.3 429 50 0.58 (0.39–0.86) 392 45 0.40 (0.25–0.63) ≥8.3 416 45 0.40 (0.29–0.59) 393 48 0.36 (0.24–0.56) Ptrend <0.001 0.002 ER+PR−/ER−PR+ (mixed) 986 87 911 94 MET-hours per weekb No exercise 338 31 1.00 308 28 1.00 <8.3 299 28 0.78 (0.42–1.43) 282 32 0.62 (0.32–1.23) ≥8.3 349 28 0.67 (0.36–1.22) 321 34 0.51 (0.27–1.00) Ptrend 0.051 0.166 Pinteraction 0.004 0.375 -
aAdjusted for date of birth, BMI at baseline, waist-to-hip ratio at baseline, menopausal status, income, education, QOL, cruciferous vegetable intake, soy protein intake, tea consumption, chemotherapy, radiotherapy, tamoxifen use, and ER/PR receptor status.
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bExercise was treated as a time-dependent variable.
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cFurther adjusted for TNM status instead of ER/PR receptor status.
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- Table 4.
Associations of exercise over the first 36 months after breast cancer diagnosis with total mortality and relapse/disease-specific mortality, stratified by menopausal status, QOL, and BMI
Total mortality Relapse/disease-specific mortality Total Events HR (95% CI) Total Events HR (95% CI) Stratified by menopausal status a Premenopause 2,359 186 2,202 208 MET-hours per weekb No exercise 835 76 1.00 773 81 1.00 <8.3 764 49 0.87 (0.58–1.10) 714 55 0.59 (0.39–0.89) ≥8.3 760 61 0.86 (0.58–1.26) 715 72 0.69 (0.47–1.00) Ptrend 0.317 0.631 Postmenopause 2,467 250 2,309 242 MET-hours per weekb No exercise 876 109 1.00 807 93 1.00 <8.3 802 73 0.82 (0.59–1.14) 754 73 0.63 (0.44–0.91) ≥8.3 789 68 0.55 (0.40–0.77) 748 76 0.52 (0.36–0.74) Ptrend <0.001 0.001 Pinteraction 0.233 0.300 Stratified by QOL c QOL < median 2,278 205 2,138 222 MET-hours per weekb No exercise 902 101 1.00 827 99 1.00 <8.3 723 56 0.63 (0.44–0.90) 681 59 0.45 (0.31–0.65) ≥8.3 653 48 0.50 (0.35–0.71) 630 64 0.47 (0.33–0.66) Ptrend <0.001 0.006 QOL ≥ median 2,548 231 2,373 228 MET-hours per weekb No exercise 809 84 1.00 753 75 1.00 <8.3 843 66 1.06 (0.73–1.55) 787 69 0.80 (0.53–1.21) ≥8.3 896 81 0.83 (0.58–1.21) 833 84 0.74 (0.50–1.10) Ptrend 0.111 0.289 Pinteraction 0.294 0.218 Stratified by BMI d BMI<25 3,128 267 2,914 266 MET-hours per weekb No exercise 1,102 113 1.00 1,015 98 1.00 <8.3 999 76 0.76 (0.55–1.05) 932 81 0.70 (0.47–0.96) ≥8.3 1,027 78 0.62 (0.45–0.85) 967 87 0.66 (0.47–0.94) Ptrend 0.002 0.033 BMI ≥ 25 1,698 169 1,597 184 MET-hours per weekb No exercise 609 72 1.00 565 76 1.00 <8.3 567 46 0.91 (0.60–1.38) 536 47 0.53 (0.35–0.81) ≥8.3 522 51 0.70 (0.46–1.05) 496 61 0.50 (0.38–0.74) Ptrend 0.027 0.095 Pinteraction 0.642 0.704 Stratified by Charlson comorbidity index Charlson comorbidity index <1 3,869 339 3,601 350 MET-hours per weekb No exercise 1,360 138 1.00 1,253 133 1.00 <8.3 1,258 98 0.89 (0.66,1.18) 1,172 101 0.65 (0.47–0.89) ≥8.3 1,251 103 0.68 (0.50–0.90) 1,176 116 0.66 (0.49–0.90) Ptrend 0.003 0.162 Charlson comorbidity index ≥1 957 97 910 100 MET-hours per weekb No exercise 351 47 1.00 327 41 1.00 <8.3 308 24 0.63 (0.36–1.10) 296 27 0.49 (0.26–0.78) ≥8.3 298 26 0.62 (0.37–1.05) 287 32 0.39 (0.23–0.66) Ptrend 0.050 0.009 Pinteraction 0.198 0.651 -
aAdjusted for date of birth, BMI at baseline, waist-to-hip ratio at baseline, income, education, QOL, cruciferous vegetable intake, soy protein intake, tea consumption, chemotherapy, radiotherapy, tamoxifen use, TNM status, and ER/PR receptor status.
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bExercise was treated as a time-dependent variable.
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cFurther adjusted for TNM status instead of QOL.
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dFurther adjusted for QOL instead of BMI.
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Volume 4, Issue 9
