Originally published as JCO Early Release 10.1200/JCO.2006.07.3965 on January 29 2007

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Physical Activity, Body Mass Index, and Mammographic Density in Postmenopausal Breast Cancer Survivors

Melinda L. Irwin, Erin J. Aiello, Anne McTiernan, Leslie Bernstein, Frank D. Gilliland, Richard N. Baumgartner, Kathy B. Baumgartner, Rachel Ballard-Barbash

From the Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT; Center for Health Studies, Group Health Cooperative; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Preventive Medicine, University of Southern California, Los Angeles, CA; Cancer Research & Treatment Center, Department of Internal Medicine, University of New Mexico, Albuquerque, NM; and the Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD

Address reprint requests to Melinda L. Irwin, PhD, MPH, Department of Epidemiology and Public Health, Yale School of Medicine, PO Box 208034, New Haven, CT 06520-8034; e-mail: melinda.irwin{at}yale.edu

Purpose To investigate the association between physical activity, body mass index (BMI), and mammographic density in a racially/ethnically diverse population-based sample of 522 postmenopausal women diagnosed with stage 0-IIIA breast cancer and enrolled in the Health, Eating, Activity, and Lifestyle Study.

Methods We collected information on BMI and physical activity during a clinic visit 2 to 3 years after diagnosis. Weight and height were measured in a standard manner. Using an interview-administered questionnaire, participants recalled the type, duration, and frequency of physical activities they had performed in the last year. We estimated dense area and percentage density as a continuous measure using a computer-assisted software program from mammograms imaged approximately 1 to 2 years after diagnosis. Analysis of covariance methods were used to obtain mean density across WHO BMI categories and physical activity tertiles adjusted for confounders.

Results We observed a statistically significant decline in percentage density (P for trend = .0001), and mammographic dense area (P for trend = .0052), with increasing level of BMI adjusted for potential covariates. We observed a statistically significant decline in mammographic dense area (P for trend = .036) with increasing level of sports/recreational physical activity in women with a BMI of at least 30 kg/m². Conversely, in women with a BMI less than 25 kg/m², we observed a non–statistically significant increase in mammographic dense area and percentage density with increasing level of sports/recreational physical activity.

Conclusion Increasing physical activity among obese postmenopausal breast cancer survivors may be a reasonable intervention approach to reduce mammographic density.

published online ahead of print at www.jco.org on January 29, 2007.

Supported by National Cancer Institute Grants No. N01-CN-75036-20, NO1-CN-05228, NO1-PC-67010, and training Grant No. T32 CA09661. A portion of this work was conducted through the Clinical Research Center at the University of Washington and supported by National Institutes of Health Grant No. M01-RR-00037, and University of New Mexico Grant No. NCRR M01-RR-0997.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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