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. 2020 Jul;182(1):215-227.
doi: 10.1007/s10549-020-05679-2. Epub 2020 May 20.

Exploring the effects of lifestyle on breast cancer risk, age at diagnosis, and survival: the EBBA-Life study

Trygve Lofterød  1 , Hanne Frydenberg  2 , Vidar Flote  2 , Anne Elise Eggen  3 , Anne McTiernan  4 , Elin S Mortensen  5 , Lars A Akslen  6   7 , Jon B Reitan  2 , Tom Wilsgaard  3 , Inger Thune  2   8
Affiliations

Exploring the effects of lifestyle on breast cancer risk, age at diagnosis, and survival: the EBBA-Life study

Trygve Lofterød et al. Breast Cancer Res Treat. 2020 Jul.

Abstract

Purpose: Whether an unfavorable lifestyle not only affects breast cancer risk, but also influences age at onset of breast cancer and survival, is under debate.

Methods: In a population-based cohort, the Energy Balance and Breast Cancer Aspects throughout life (EBBA-Life) study, a total of 17,145 women were included. During follow-up, 574 women developed invasive breast cancer. Breast cancer cases were followed for an additional 9.1 years. Detailed medical records were obtained. Cox's proportional hazard regression models were used to study the association between pre-diagnostic lifestyle factors (weight, physical activity, alcohol use, smoking, and hypertension), breast cancer risk, age at diagnosis, and survival.

Results: At study entry, 34.3% of the participating women were overweight and 30.7% were physically inactive. Mean age at breast cancer diagnosis was 58.0 years, and 78.9% of the tumors were estrogen receptor positive. Among menopausal women who did not use hormone therapy and had an unfavorable lifestyle (3-5 unfavorable factors), compared with women who had a favorable lifestyle, we observed a twofold higher risk for postmenopausal breast cancer (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.23-3.69), and they were 3.4 years younger at diagnosis (64.8 versus 68.2 years, P = 0.032). Breast cancer patients with an unfavorable lifestyle, compared with patients with a favorable lifestyle, had almost a two times higher overall mortality risk (HR 1.96, 95% CI 1.01-3.80).

Conclusions: Our study supports a healthy lifestyle improving breast cancer prevention, postponing onset of disease, and extending life expectancy among breast cancer patients.

Keywords: Breast cancer; Lifestyle; Onset; Risk; Survival.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Breast cancer incidence rate in the period between 1995 and 2017 among: a women aged 30–90 years, b women aged 30–55 years, and c women aged 55–90 years
Fig. 2
Fig. 2
Women diagnosed with breast cancer in the EBBA-Life study (n = 574). Number of unfavorable lifestyle factors and a overall mortality, and b breast cancer mortality Adjusted for age
See this image and copyright information in PMC

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