BACKGROUND: Among postmenopausal breast cancer survivors, poor physical health has been associated with higher risks of breast cancer events. Obesity and physical inactivity are known risk factors for poor physical health, while circulating estrogen is an additional potential risk factor. We tested the hypothesis that the relationship between poor physical health and worse breast cancer outcomes is mediated by higher estrogen concentrations associated with body size and physical inactivity. METHODS: We used data from 1030 postmenopausal breast cancer survivors to examine the association between serum estradiol levels, body mass index (BMI), physical activity, and RAND-36-item Health Survey (SF-36) physical health. RESULTS: In univariate analysis, poor physical health was associated with higher estradiol levels, in addition to obesity and low physical activity. Higher estradiol levels were significantly associated with higher odds of poor physical health (odds ratio, OR, 1.20 [95% confidence interval 1.03-1.39]) in a multivariable model adjusting for age, cancer stage and treatment, alcohol use, and physical activity. However, the relationship between estradiol levels and poor physical health was no longer significant (OR 1.06 [0.91-1.24]) after adding BMI in the model. In multivariate analysis, only poor physical health resulted in higher risks of recurrence (hazard ratio 1.33 [95% CI 1.08-1.64]). CONCLUSIONS: These findings indicate that estradiol is related to poor physical health, but is not an independent risk factor from body size or inactivity. While obesity and physical activity in survivorship are potential targets for improving physical health, other biological processes that impact physical health, e.g. inflammation, remain to be identified.
BACKGROUND: Among postmenopausal breast cancer survivors, poor physical health has been associated with higher risks of breast cancer events. Obesity and physical inactivity are known risk factors for poor physical health, while circulating estrogen is an additional potential risk factor. We tested the hypothesis that the relationship between poor physical health and worse breast cancer outcomes is mediated by higher estrogen concentrations associated with body size and physical inactivity. METHODS: We used data from 1030 postmenopausal breast cancer survivors to examine the association between serum estradiol levels, body mass index (BMI), physical activity, and RAND-36-item Health Survey (SF-36) physical health. RESULTS: In univariate analysis, poor physical health was associated with higher estradiol levels, in addition to obesity and low physical activity. Higher estradiol levels were significantly associated with higher odds of poor physical health (odds ratio, OR, 1.20 [95% confidence interval 1.03-1.39]) in a multivariable model adjusting for age, cancer stage and treatment, alcohol use, and physical activity. However, the relationship between estradiol levels and poor physical health was no longer significant (OR 1.06 [0.91-1.24]) after adding BMI in the model. In multivariate analysis, only poor physical health resulted in higher risks of recurrence (hazard ratio 1.33 [95% CI 1.08-1.64]). CONCLUSIONS: These findings indicate that estradiol is related to poor physical health, but is not an independent risk factor from body size or inactivity. While obesity and physical activity in survivorship are potential targets for improving physical health, other biological processes that impact physical health, e.g. inflammation, remain to be identified.
Authors: Paul E Goss; James N Ingle; Silvana Martino; Nicholas J Robert; Hyman B Muss; Martine J Piccart; Monica Castiglione; Dongsheng Tu; Lois E Shepherd; Kathleen I Pritchard; Robert B Livingston; Nancy E Davidson; Larry Norton; Edith A Perez; Jeffrey S Abrams; Patrick Therasse; Michael J Palmer; Joseph L Pater Journal: N Engl J Med Date: 2003-10-09 Impact factor: 91.245
Authors: John P Pierce; Marcia L Stefanick; Shirley W Flatt; Loki Natarajan; Barbara Sternfeld; Lisa Madlensky; Wael K Al-Delaimy; Cynthia A Thomson; Sheila Kealey; Richard Hajek; Barbara A Parker; Vicky A Newman; Bette Caan; Cheryl L Rock Journal: J Clin Oncol Date: 2007-06-10 Impact factor: 44.544
Authors: T J Key; P N Appleby; G K Reeves; A Roddam; J F Dorgan; C Longcope; F Z Stanczyk; H E Stephenson; R T Falk; R Miller; A Schatzkin; D S Allen; I S Fentiman; T J Key; D Y Wang; M Dowsett; H V Thomas; S E Hankinson; P Toniolo; A Akhmedkhanov; K Koenig; R E Shore; A Zeleniuch-Jacquotte; F Berrino; P Muti; A Micheli; V Krogh; S Sieri; V Pala; E Venturelli; G Secreto; E Barrett-Connor; G A Laughlin; M Kabuto; S Akiba; R G Stevens; K Neriishi; C E Land; J A Cauley; L H Kuller; S R Cummings; K J Helzlsouer; A J Alberg; T L Bush; G W Comstock; G B Gordon; S R Miller; C Longcope Journal: J Natl Cancer Inst Date: 2003-08-20 Impact factor: 13.506
Authors: Phyo K Myint; Robert N Luben; Paul G Surtees; Nicholas W J Wainwright; Ailsa A Welch; Sheila A Bingham; Nicholas E Day; Nicholas J Wareham; Kay-Tee Khaw Journal: Ann Epidemiol Date: 2005-07-06 Impact factor: 3.797
Authors: Fausto Petrelli; Alessio Cortellini; Alice Indini; Gianluca Tomasello; Michele Ghidini; Olga Nigro; Massimiliano Salati; Lorenzo Dottorini; Alessandro Iaculli; Antonio Varricchio; Valentina Rampulla; Sandro Barni; Mary Cabiddu; Antonio Bossi; Antonio Ghidini; Alberto Zaniboni Journal: JAMA Netw Open Date: 2021-03-01