Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer: a randomized controlled trial

Kathryn Schmitz, Nancy Williams, Despina Kontos, Susan Domchek, Knashawn H. Morales, Wei Ting Hwang, Lorita L. Grant, Laura DiGiovanni, Domenick Salvatore, Desire’ Fenderson, Mitchell Schnall, Mary Lou Galantino, Jill Stopfer, Mindy S. Kurzer, Shandong Wu, Jessica Adelman, Justin C. Brown, Jerene Good

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Medical and surgical interventions for elevated breast cancer risk (e.g., BRCA1/2 mutation, family history) focus on reducing estrogen exposure. Women at elevated risk may be interested in less aggressive approaches to risk reduction. For example, exercise might reduce estrogen, yet has fewer serious side effects and less negative impact than surgery or hormonal medications. Randomized controlled trial. Increased risk defined by risk prediction models or BRCA mutation status. Eligibility: Age 18–50, eumenorrheic, non-smokers, and body mass index (BMI) between 21 and 50 kg/m2. 139 were randomized. Treadmill exercise: 150 or 300 min/week, five menstrual cycles. Control group maintained exercise <75 min/week. Primary outcome: Area under curve (AUC) for urinary estrogen. Secondary measures: urinary progesterone, quantitative digitized breast dynamic contrast-enhanced magnetic resonance imaging background parenchymal enhancement. Mean age 34 years, mean BMI 26.8 kg/m2. A linear dose–response relationship was observed such that every 100 min of exercise is associated with 3.6 % lower follicular phase estrogen AUC (linear trend test, p = 0.03). No changes in luteal phase estrogen or progesterone levels. There was also a dose–response effect noted: for every 100 min of exercise, there was a 9.7 % decrease in background parenchymal enhancement as measured by imaging (linear trend test, p = 0.009). Linear dose–response effect observed to reduce follicular phase estrogen exposure measured via urine and hormone sensitive breast tissue as measured by imaging. Future research should explore maintenance of effects and extent to which findings are repeatable in lower risk women. Given the high benefit to risk ratio, clinicians can inform young women at increased risk that exercise may blunt estrogen exposure while considering whether to try other preventive therapies.

Original languageEnglish (US)
Pages (from-to)309-318
Number of pages10
JournalBreast Cancer Research and Treatment
Volume154
Issue number2
DOIs
StatePublished - Nov 1 2015

Fingerprint

Estrogens
Randomized Controlled Trials
Exercise
Breast Neoplasms
Follicular Phase
Area Under Curve
Progesterone
Breast
Body Mass Index
Mutation
Luteal Phase
Risk Reduction Behavior
Menstrual Cycle
Odds Ratio
Maintenance
Magnetic Resonance Imaging
Urine
Hormones
Control Groups

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Schmitz, Kathryn ; Williams, Nancy ; Kontos, Despina ; Domchek, Susan ; Morales, Knashawn H. ; Hwang, Wei Ting ; Grant, Lorita L. ; DiGiovanni, Laura ; Salvatore, Domenick ; Fenderson, Desire’ ; Schnall, Mitchell ; Galantino, Mary Lou ; Stopfer, Jill ; Kurzer, Mindy S. ; Wu, Shandong ; Adelman, Jessica ; Brown, Justin C. ; Good, Jerene. / Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer : a randomized controlled trial. In: Breast Cancer Research and Treatment. 2015 ; Vol. 154, No. 2. pp. 309-318.
@article{e4adc79a57fb4b5fb5135e4baf592afc,
title = "Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer: a randomized controlled trial",
abstract = "Medical and surgical interventions for elevated breast cancer risk (e.g., BRCA1/2 mutation, family history) focus on reducing estrogen exposure. Women at elevated risk may be interested in less aggressive approaches to risk reduction. For example, exercise might reduce estrogen, yet has fewer serious side effects and less negative impact than surgery or hormonal medications. Randomized controlled trial. Increased risk defined by risk prediction models or BRCA mutation status. Eligibility: Age 18–50, eumenorrheic, non-smokers, and body mass index (BMI) between 21 and 50 kg/m2. 139 were randomized. Treadmill exercise: 150 or 300 min/week, five menstrual cycles. Control group maintained exercise <75 min/week. Primary outcome: Area under curve (AUC) for urinary estrogen. Secondary measures: urinary progesterone, quantitative digitized breast dynamic contrast-enhanced magnetic resonance imaging background parenchymal enhancement. Mean age 34 years, mean BMI 26.8 kg/m2. A linear dose–response relationship was observed such that every 100 min of exercise is associated with 3.6 {\%} lower follicular phase estrogen AUC (linear trend test, p = 0.03). No changes in luteal phase estrogen or progesterone levels. There was also a dose–response effect noted: for every 100 min of exercise, there was a 9.7 {\%} decrease in background parenchymal enhancement as measured by imaging (linear trend test, p = 0.009). Linear dose–response effect observed to reduce follicular phase estrogen exposure measured via urine and hormone sensitive breast tissue as measured by imaging. Future research should explore maintenance of effects and extent to which findings are repeatable in lower risk women. Given the high benefit to risk ratio, clinicians can inform young women at increased risk that exercise may blunt estrogen exposure while considering whether to try other preventive therapies.",
author = "Kathryn Schmitz and Nancy Williams and Despina Kontos and Susan Domchek and Morales, {Knashawn H.} and Hwang, {Wei Ting} and Grant, {Lorita L.} and Laura DiGiovanni and Domenick Salvatore and Desire’ Fenderson and Mitchell Schnall and Galantino, {Mary Lou} and Jill Stopfer and Kurzer, {Mindy S.} and Shandong Wu and Jessica Adelman and Brown, {Justin C.} and Jerene Good",
year = "2015",
month = "11",
day = "1",
doi = "10.1007/s10549-015-3604-z",
language = "English (US)",
volume = "154",
pages = "309--318",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "2",

}

Schmitz, K, Williams, N, Kontos, D, Domchek, S, Morales, KH, Hwang, WT, Grant, LL, DiGiovanni, L, Salvatore, D, Fenderson, D, Schnall, M, Galantino, ML, Stopfer, J, Kurzer, MS, Wu, S, Adelman, J, Brown, JC & Good, J 2015, 'Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer: a randomized controlled trial', Breast Cancer Research and Treatment, vol. 154, no. 2, pp. 309-318. https://doi.org/10.1007/s10549-015-3604-z

Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer : a randomized controlled trial. / Schmitz, Kathryn; Williams, Nancy; Kontos, Despina; Domchek, Susan; Morales, Knashawn H.; Hwang, Wei Ting; Grant, Lorita L.; DiGiovanni, Laura; Salvatore, Domenick; Fenderson, Desire’; Schnall, Mitchell; Galantino, Mary Lou; Stopfer, Jill; Kurzer, Mindy S.; Wu, Shandong; Adelman, Jessica; Brown, Justin C.; Good, Jerene.

In: Breast Cancer Research and Treatment, Vol. 154, No. 2, 01.11.2015, p. 309-318.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dose–response effects of aerobic exercise on estrogen among women at high risk for breast cancer

T2 - a randomized controlled trial

AU - Schmitz, Kathryn

AU - Williams, Nancy

AU - Kontos, Despina

AU - Domchek, Susan

AU - Morales, Knashawn H.

AU - Hwang, Wei Ting

AU - Grant, Lorita L.

AU - DiGiovanni, Laura

AU - Salvatore, Domenick

AU - Fenderson, Desire’

AU - Schnall, Mitchell

AU - Galantino, Mary Lou

AU - Stopfer, Jill

AU - Kurzer, Mindy S.

AU - Wu, Shandong

AU - Adelman, Jessica

AU - Brown, Justin C.

AU - Good, Jerene

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Medical and surgical interventions for elevated breast cancer risk (e.g., BRCA1/2 mutation, family history) focus on reducing estrogen exposure. Women at elevated risk may be interested in less aggressive approaches to risk reduction. For example, exercise might reduce estrogen, yet has fewer serious side effects and less negative impact than surgery or hormonal medications. Randomized controlled trial. Increased risk defined by risk prediction models or BRCA mutation status. Eligibility: Age 18–50, eumenorrheic, non-smokers, and body mass index (BMI) between 21 and 50 kg/m2. 139 were randomized. Treadmill exercise: 150 or 300 min/week, five menstrual cycles. Control group maintained exercise <75 min/week. Primary outcome: Area under curve (AUC) for urinary estrogen. Secondary measures: urinary progesterone, quantitative digitized breast dynamic contrast-enhanced magnetic resonance imaging background parenchymal enhancement. Mean age 34 years, mean BMI 26.8 kg/m2. A linear dose–response relationship was observed such that every 100 min of exercise is associated with 3.6 % lower follicular phase estrogen AUC (linear trend test, p = 0.03). No changes in luteal phase estrogen or progesterone levels. There was also a dose–response effect noted: for every 100 min of exercise, there was a 9.7 % decrease in background parenchymal enhancement as measured by imaging (linear trend test, p = 0.009). Linear dose–response effect observed to reduce follicular phase estrogen exposure measured via urine and hormone sensitive breast tissue as measured by imaging. Future research should explore maintenance of effects and extent to which findings are repeatable in lower risk women. Given the high benefit to risk ratio, clinicians can inform young women at increased risk that exercise may blunt estrogen exposure while considering whether to try other preventive therapies.

AB - Medical and surgical interventions for elevated breast cancer risk (e.g., BRCA1/2 mutation, family history) focus on reducing estrogen exposure. Women at elevated risk may be interested in less aggressive approaches to risk reduction. For example, exercise might reduce estrogen, yet has fewer serious side effects and less negative impact than surgery or hormonal medications. Randomized controlled trial. Increased risk defined by risk prediction models or BRCA mutation status. Eligibility: Age 18–50, eumenorrheic, non-smokers, and body mass index (BMI) between 21 and 50 kg/m2. 139 were randomized. Treadmill exercise: 150 or 300 min/week, five menstrual cycles. Control group maintained exercise <75 min/week. Primary outcome: Area under curve (AUC) for urinary estrogen. Secondary measures: urinary progesterone, quantitative digitized breast dynamic contrast-enhanced magnetic resonance imaging background parenchymal enhancement. Mean age 34 years, mean BMI 26.8 kg/m2. A linear dose–response relationship was observed such that every 100 min of exercise is associated with 3.6 % lower follicular phase estrogen AUC (linear trend test, p = 0.03). No changes in luteal phase estrogen or progesterone levels. There was also a dose–response effect noted: for every 100 min of exercise, there was a 9.7 % decrease in background parenchymal enhancement as measured by imaging (linear trend test, p = 0.009). Linear dose–response effect observed to reduce follicular phase estrogen exposure measured via urine and hormone sensitive breast tissue as measured by imaging. Future research should explore maintenance of effects and extent to which findings are repeatable in lower risk women. Given the high benefit to risk ratio, clinicians can inform young women at increased risk that exercise may blunt estrogen exposure while considering whether to try other preventive therapies.

UR - http://www.scopus.com/inward/record.url?scp=84947488182&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947488182&partnerID=8YFLogxK

U2 - 10.1007/s10549-015-3604-z

DO - 10.1007/s10549-015-3604-z

M3 - Article

C2 - 26510851

AN - SCOPUS:84947488182

VL - 154

SP - 309

EP - 318

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -