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

17 Scopus citations

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Jones, L. W., Kwan, M. L., Weltzien, E., Chandarlapaty, S., Sternfeld, B., Sweeney, C., Bernard, P. S., Castillo, A., Habel, L. A., Kroenke, C. H., Langholz, B. M., Queensberry, C. P., Dang, C., Weigelt, B., Kushi, L. H., & 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