Abstract
BRCA1/2 mutation carriers have a high lifetime risk of developing breast cancer. Differences in penetrance indicate that this risk may be influenced by lifestyle factors. Because physical activity is one of the few modifiable risk factors, it may provide a target to add to breast cancer prevention in this high-risk population. We examined the association between self-reported lifetime sports activity and breast cancer risk in a nationwide retrospective cohort study, including 725 carriers, of whom 218 had been diagnosed with breast cancer within 10 years prior to questionnaire completion. We found a nonsignificantly decreased risk for ever engaging in sports activity (HR = 0.84, 95%CI = 0.57–1.24). Among women who had participated in sports, a medium versus low level of intensity and duration (i.e., between 11.0 and 22.7 mean MET hours/week averaged over a lifetime) reduced the risk of breast cancer (HR = 0.59, 95%CI = 0.36–0.95); no dose–response trend was observed. For mean hours/week of sports activity, a nonsignificant trend was observed (HRlow versus never = 0.93, 95%CI = 0.60–1.43; HRmedium versus never = 0.81, 95%CI = 0.51–1.29; HRhigh versus never = 0.78, 95%CI = 0.48–1.29; p trend overall = 0.272; p trend active women = 0.487). For number of years of sports activity no significant associations were found. Among women active in sports before age 30, mean MET hours/week showed the strongest inverse association of all activity measures (HRmedium versus low = 0.60, 95%CI = 0.38–0.96; HRhigh versus low = 0.58, 95%CI = 0.35–0.94; p trend = 0.053). Engaging in sports activity after age 30 was also inversely associated with breast cancer risk (HR = 0.63, 95%CI = 0.44–0.91). Our results indicate that sports activity may reduce the risk of breast cancer in BRCA1/2 mutation carriers.
Similar content being viewed by others
References
Antoniou A, Pharoah PD, Narod S et al (2003) Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case Series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet 72(5):1117–1130
Chen S, Iversen ES, Friebel T et al (2006) Characterization of BRCA1 and BRCA2 mutations in a large United States sample. J Clin Oncol 24(6):863–871
Easton DF, Ford D, Bishop DT (1995) Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast cancer linkage consortium. Am J Hum Genet 56(1):265–271
Evans DG, Shenton A, Woodward E, Lalloo F, Howell A, Maher ER (2008) Penetrance estimates for BRCA1 and BRCA2 based on genetic testing in a clinical cancer genetics service setting: risks of breast/ovarian cancer quoted should reflect the cancer burden in the family. BMC Cancer 8(1):155
Ford D, Easton DF, Stratton M et al (1998) Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. The breast cancer linkage consortium. Am J Hum Genet 62(3):676–689
King MC, Marks JH, Mandell JB (2003) Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2. Science 302(5645):643–646
Narod SA, Foulkes WD (2004) BRCA1 and BRCA2: 1994 and beyond. Nat Rev Cancer 4(9):665–676
Narod SA (2006) Modifiers of risk of hereditary breast cancer. Oncogene 25(43):5832–5836
Monninkhof EM, Elias SG, Vlems FA et al (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18(1):137–157
World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity, the Prevention of Cancer; A Global Perspective. AICR, Washington, DC, Ref Type: Report
Lahmann PH, Friedenreich C, Schuit AJ et al (2007) Physical activity and breast cancer risk: the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 16(1):36–42
Sprague BL, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Hampton JM, Newcomb PA (2008) Proportion of invasive breast cancer attributable to risk factors modifiable after menopause. Am J Epidemiol 168(4):404–411
Friedenreich CM, Cust AE (2008) Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br J Sports Med 42(8):636–647
Maruti SS, Willett WC, Feskanich D, Rosner B, Colditz GA (2008) A prospective study of age-specific physical activity and premenopausal breast cancer. J Natl Cancer Inst 100(10):728–737
Suzuki S, Kojima M, Tokudome S et al (2008) Effect of physical activity on breast cancer risk: findings of the Japan collaborative cohort study. Cancer Epidemiol Biomarkers Prev 17(12):3396–3401
Howard RA, Leitzmann MF, Linet MS, Freedman DM (2009) Physical activity and breast cancer risk among pre- and postmenopausal women in the U.S. radiologic technologists cohort. Cancer Causes Control 20(3):323–333
Nkondjock A, Robidoux A, Paredes Y, Narod SA, Ghadirian P (2006) Diet, lifestyle and BRCA-related breast cancer risk among French-Canadians. Breast Cancer Res Treat 98(3):285–294
Casparie M, Tiebosch AT, Burger G et al (2007) Pathology databanking and biobanking in The Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive. Cell Oncol 29(1):19–24
Belza B, Warms C (2004) Physical activity and exercise in women’s health. Nurs Clin North Am 39(1):181–193, viii
Oguma Y, Sesso HD, Paffenbarger RS Jr, Lee IM (2002) Physical activity and all cause mortality in women: a review of the evidence. Br J Sports Med 36(3):162–172
Kellen E, Vansant G, Christiaens MR, Neven P, Van Limbergen E (2009) Lifestyle changes and breast cancer prognosis: a review. Breast Cancer Res Treat 114(1):13–22
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–2486
Friedenreich CM, Gregory J, Kopciuk KA, Mackey JR, Courneya KS (2009) Prospective cohort study of lifetime physical activity and breast cancer survival. Int J Cancer 124(8):1954–1962
Andrieu N, Easton DF, Chang-Claude J et al (2006) Effect of chest X-rays on the risk of breast cancer among BRCA1/2 mutation carriers in the international BRCA1/2 carrier cohort study: a report from the EMBRACE, GENEPSO, GEO-HEBON, and IBCCS collaborators’ group. J Clin Oncol 24(21):3361–3366
Brohet RM, Goldgar DE, Easton DF et al (2007) Oral contraceptives and breast cancer risk in the international BRCA1/2 carrier cohort study: a report from EMBRACE, GENEPSO, GEO-HEBON, and the IBCCS collaborating group. J Clin Oncol 25(25):3831–3836
Andrieu N, Goldgar DE, Easton DF et al (2006) Pregnancies, breast-feeding, and breast cancer risk in the international BRCA1/2 carrier cohort study (IBCCS). J Natl Cancer Inst 98(8):535–544
Ainsworth BE, Haskell WL, Leon AS et al (1993) Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 25(1):71–80
Ainsworth BE, Haskell WL, Whitt MC et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498–S504
Antoniou AC, Goldgar DE, Andrieu N et al (2005) A weighted cohort approach for analysing factors modifying disease risks in carriers of high-risk susceptibility genes. Genet Epidemiol 29(1):1–11
Rubinstein WS (2008) Hereditary breast cancer: pathobiology, clinical translation, and potential for targeted cancer therapeutics. Fam Cancer 7(1):83–89
Silva E, Gatalica Z, Snyder C, Vranic S, Lynch JF, Lynch HT (2008) Hereditary breast cancer: part II. Management of hereditary breast cancer: implications of molecular genetics and pathology. Breast J 14(1):14–24
Bermejo-Perez MJ, Marquez-Calderon S, Llanos-Mendez A (2007) Effectiveness of preventive interventions in BRCA1/2 gene mutation carriers: a systematic review. Int J Cancer 121(2):225–231
Hosey AM, Gorski JJ, Murray MM et al (2007) Molecular basis for estrogen receptor alpha deficiency in BRCA1-linked breast cancer. J Natl Cancer Inst 99(22):1683–1694
Friedenreich CM, Orenstein MR (2002) Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr 132(11 Suppl):3456S–3464S
McTiernan A (2008) Mechanisms linking physical activity with cancer. Nat Rev Cancer 8(3):205–211
Neilson HK, Friedenreich CM, Brockton NT, Millikan RC (2009) Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev 18(1):11–27
Friedenreich CM (2004) Physical activity and breast cancer risk: the effect of menopausal status. Exerc Sport Sci Rev 32(4):180–184
Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4(8):579–591
Baecke JA, Burema J, Frijters JE (1982) A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 36(5):936–942
Maruti SS, Willett WC, Feskanich D, Levine B, Rosner B, Colditz GA (2009) Physical activity and premenopausal breast cancer: an examination of recall and selection bias. Cancer Causes Control 20(5):549–558
Falkner KL, Trevisan M, McCann SE (1999) Reliability of recall of physical activity in the distant past. Am J Epidemiol 150(2):195–205
Acknowledgments
This work was financially supported by the Dutch Cancer Society (grants NKI1998-1854, NKI2004-3088, NKI 2007-3756).
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
The Netherlands Collaborative Group on Hereditary Breast Cancer (HEBON) is given in Appendix.
Appendix
Appendix
The Netherlands Collaborative Group on Hereditary Breast Cancer (HEBON): Coordinating center: Netherlands Cancer Institute, Amsterdam: Senno Verhoef, Anouk Pijpe, Richard Brohet, Frans Hogervorst, Laura van ‘t Veer, Flora van Leeuwen, Matti Rookus; Erasmus Medical Center, Rotterdam: Margriet Collée, Ans van den Ouweland, Mieke Kriege, Mieke Schutte, Maartje Hooning, Caroline Seynaeve; Leiden University Medical Center, Leiden: Christi van Asperen, Juul Wijnen, Peter Devilee; Radboud University Nijmegen Medical Center, Nijmegen: Nicoline Hoogerbrugge, Marjolijn Ligtenberg; University Medical Center Utrecht, Utrecht: Margreet Ausems, Rob van der Luijt; Amsterdam Medical Center: Cora Aalfs, Theo van Os; VU University Medical Center, Amsterdam: Hanne Meijers-Heijboer, Hans Gille; University Hospital Maastricht, Maastricht: Encarna Gomez-Garcia, Rien Blok; University Medical Center Groningen, Groningen: Jan Oosterwijk, Annemiek van der Hout; Netherlands Foundation for Detection of Hereditary Tumours, Leiden: Hans Vasen, Inge van Leeuwen.
Rights and permissions
About this article
Cite this article
Pijpe, A., Manders, P., Brohet, R.M. et al. Physical activity and the risk of breast cancer in BRCA1/2 mutation carriers. Breast Cancer Res Treat 120, 235–244 (2010). https://doi.org/10.1007/s10549-009-0476-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-009-0476-0