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American Journal of Epidemiology Advance Access published online on December 27, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm350
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTION

Physical Activity and Mammographic Breast Density in the EPIC-Norfolk Cohort Study

Tricia M. Peters1,2, Ulf Ekelund1, Michael Leitzmann2, Douglas Easton3, Ruth Warren4, Robert Luben5, Sheila Bingham6, Kay-Tee Khaw7 and Nicholas J. Wareham1

1 MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
2 National Cancer Institute, National Institutes of Health, Bethesda, MD
3 Cancer Research UK, Genetic Epidemiology Group, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
4 Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
5 Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
6 MRC Dunn Human Nutrition Unit, Cambridge, United Kingdom
7 Clinical Gerontology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom

Correspondence to Dr. Ulf Ekelund, MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge, United Kingdom CB2 0QQ (e-mail: ulf.ekelund{at}mrc-epid.cam.ac.uk).

Received for publication July 20, 2007. Accepted for publication October 31, 2007.

Physical inactivity and high mammographic breast density have both been associated with increased breast cancer risk. However, the association between physical activity and mammographic breast density remains inconsistent. In the European Prospective Investigation of Cancer (EPIC)-Norfolk population-based cohort study (United Kingdom), the authors investigated the cross-sectional association between physical activity level at baseline during 1993–1997 and breast density among 1,394 postmenopausal, cancer-free women. Usual physical activity was assessed by a brief, validated questionnaire. Percentage breast density was determined visually from mammograms by three trained radiologists using the Boyd six-category scale. The association between physical activity level and breast density risk category was examined. No statistically significant association between physical activity and percentage breast density was observed in the unadjusted or adjusted regression models. A suggested increase in breast density for the most active women in the unadjusted regression analysis (odds ratio = 1.13, 95% confidence interval: 0.71, 1.80) was reversed after inclusion of body mass index and reproductive and lifestyle variables (odds ratio = 0.78, 95% confidence interval: 0.45, 1.34). The lack of an association between physical activity and percentage breast density suggests that an association between physical activity and breast cancer risk is unlikely to be mediated through an effect on mammographic breast density.

breast; breast neoplasms; exercise; mammography; motor activity

Abbreviations: BMI, body mass index; EPIC, European Prospective Investigation of Cancer


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