Abstract P3-03-15: Physical Activity and Risk of Death in Breast Cancer Survivors: A Prospective Study

Abstract BACKGROUND. Strong evidence exists supporting the protective effect of physical activity on the risk of developing breast cancer; however, its impact on survival after breast cancer diagnosis remains controversial with limited research in long-term survivors. The aim of the current study was to evaluate the association of physical activity and risk of all-cause mortality in long-term breast cancer survivors. METHODS. We conducted a prospective cohort of 315 post-menopausal breast cancer survivors who were at least 2 years post their initial diagnosis (median 6 years of survivorship). They initially were diagnosed with early stage (AJCC TNM Stages 0-II) breast cancer between January 1996-December 2012. Baseline interviews were conducted between August 2013 and March 2015, and participants were followed until date of death or study’s end (April 2022). Subjects were queried on physical activity and fatigue using validated questionnaires, Godin Leisure Physical Activity Scale (GLPAS) and Fatigue Symptom Inventory (FSI). Physical activity was defined in 3 levels (active, moderately active, insufficiently active). Cox proportional hazards regression model was used to estimate the association of physical activity with risk of all-cause mortality, adjusted for age at baseline, breast cancer stage, Charlson comorbidity index (CCI), years since cancer diagnosis, fatigue, race/ethnicity, lifetime history of insomnia and depression, and adjuvant cancer treatments (endocrine, chemotherapy and radiation). RESULTS. Of the 315 women, mean age at interview was 71 years (range: 57-86). The cohort included 30% women of color, mainly African American/Black and Asian/Pacific Islander women. Over a maximum follow-up of 8.7 years (median:7.8, IQR:7.3-8.3) after their baseline interview, 45 subjects (14.3%) died due to all causes. The mortality rates were: 12.9 per 1000 person years (PY) for active; 13.4 per 1000 PY for moderately active; and 32.9 per 1000 PY for insufficiently active. In multivariable analysis, compared to insufficiently active women, those who were active or moderately active had a markedly 60% decreased risk of death (active: HR=0.42, 95% CI: 0.21-0.85; moderately active: HR=0.40, 95% CI:0.17-0.95). CONCLUSION: We found that even moderate physical activity was associated with a significantly decreased risk of all-cause death in long-term breast cancer survivors. Survivorship care plans should consider incorporating physical activity because even moderate activity is vital for extending survival as well as health-related quality of life. Citation Format: Lie Hong Chen, Michael R. Irwin, Richard Olmstead, Reina Haque. Physical Activity and Risk of Death in Breast Cancer Survivors: A Prospective Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-15.