Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer: The LACE and pathways studies

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

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)5415-5422
Number of pages8
JournalCancer Research
Volume76
Issue number18
DOIs
StatePublished - Sep 15 2016
Externally publishedYes

Fingerprint

Exercise
Breast Neoplasms
Confidence Intervals
Neoplasms
Recurrence
Risk Reduction Behavior
Proportional Hazards Models
Cohort Studies
Population
Genes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Jones, L. W., Kwan, M. L., Weltzien, E., Chandarlapaty, S., Sternfeld, B., Sweeney, C., ... Caan, B. J. (2016). Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer: The LACE and pathways studies. Cancer Research, 76(18), 5415-5422. https://doi.org/10.1158/0008-5472.CAN-15-3307

Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer : The LACE and pathways studies. / Jones, Lee W.; 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; Weigelt, Britta; Kushi, Lawrence H.; Caan, Bette J.

In: Cancer Research, Vol. 76, No. 18, 15.09.2016, p. 5415-5422.

Research output: Contribution to journalArticle

Jones, LW, Kwan, ML, Weltzien, E, Chandarlapaty, S, Sternfeld, B, Sweeney, C, Bernard, PS, Castillo, A, Habel, LA, Kroenke, CH, Langholz, BM, Queensberry, CP, Dang, C, Weigelt, B, Kushi, LH & Caan, BJ 2016, 'Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer: The LACE and pathways studies', Cancer Research, vol. 76, no. 18, pp. 5415-5422. https://doi.org/10.1158/0008-5472.CAN-15-3307
Jones, Lee W. ; 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 ; Weigelt, Britta ; Kushi, Lawrence H. ; Caan, Bette J. / Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer : The LACE and pathways studies. In: Cancer Research. 2016 ; Vol. 76, No. 18. pp. 5415-5422.
@article{0e44c40d35d14ca4922c259b1723944d,
title = "Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer: The LACE and pathways studies",
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.",
author = "Jones, {Lee W.} and Kwan, {Marilyn L.} and Erin Weltzien and Sarat Chandarlapaty and Barbara Sternfeld and Carol Sweeney and Bernard, {Philip S.} and Adrienne Castillo and Habel, {Laurel A.} and Kroenke, {Candyce H.} and Langholz, {Bryan M.} and Queensberry, {Charles P.} and Chau Dang and Britta Weigelt and Kushi, {Lawrence H.} and Caan, {Bette J.}",
year = "2016",
month = "9",
day = "15",
doi = "10.1158/0008-5472.CAN-15-3307",
language = "English (US)",
volume = "76",
pages = "5415--5422",
journal = "Journal of Cancer Research",
issn = "0099-7013",
publisher = "American Association for Cancer Research Inc.",
number = "18",

}

TY - JOUR

T1 - Exercise and prognosis on the basis of clinicopathologic and molecular features in early-stage breast cancer

T2 - The LACE and pathways studies

AU - Jones, Lee W.

AU - Kwan, Marilyn L.

AU - Weltzien, Erin

AU - Chandarlapaty, Sarat

AU - Sternfeld, Barbara

AU - Sweeney, Carol

AU - Bernard, Philip S.

AU - Castillo, Adrienne

AU - Habel, Laurel A.

AU - Kroenke, Candyce H.

AU - Langholz, Bryan M.

AU - Queensberry, Charles P.

AU - Dang, Chau

AU - Weigelt, Britta

AU - Kushi, Lawrence H.

AU - Caan, Bette J.

PY - 2016/9/15

Y1 - 2016/9/15

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84988939436&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988939436&partnerID=8YFLogxK

U2 - 10.1158/0008-5472.CAN-15-3307

DO - 10.1158/0008-5472.CAN-15-3307

M3 - Article

C2 - 27488523

AN - SCOPUS:84988939436

VL - 76

SP - 5415

EP - 5422

JO - Journal of Cancer Research

JF - Journal of Cancer Research

SN - 0099-7013

IS - 18

ER -