JCO Early Release, published online ahead of print Jan 29 2007
Journal of Clinical Oncology, 10.1200/JCO.2006.07.3965
Received May 10, 2006
Accepted December 12, 2006
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, and 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.
* To whom correspondence should be addressed. 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.
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