{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:56:45Z","timestamp":1793087805929,"version":"4.5.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Women with a history of breast cancer (BC) experience greater physical health decline compared with age-matched women without cancer. However, whether this decline differs in patients who received chemotherapy and endocrine therapy is not well understood.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate physical health decline in BC survivors who received chemotherapy or endocrine therapy compared with age-matched women without cancer.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This prospective cohort study was conducted as part of the Cancer Prevention Study-3, a prospective US cohort study that enrolled participants in 35 states, the District of Columbia, and Puerto Rico between 2006 and 2013. Follow-up for this analysis was through April 1, 2020. Statistical analyses were conducted between May 2023 and December 2024. Female participants diagnosed with nonmetastatic BC who returned a survey at least 90 days after their diagnosis were matched on age and year of survey return with up to 5 women without cancer.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Cancer status and treatment information.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Outcomes of interest were measures of physical health, assessed using the Patient-Reported Outcomes Measurement Information System Global Health Scale instrument. Linear regression was used to estimate associations (\u03b2) and 95% CIs of treatment with physical health.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n This analysis included 2566 individuals diagnosed with BC and 12\u202f826 age-matched women without cancer. Median (IQR) age at diagnosis was 56.3 (49.9-61.9) years. Of women with BC, 1223 (47.7%) received endocrine therapy, 276 (10.8%) received chemotherapy, and 634 (24.7%) received both. Compared with women without cancer, there was a greater physical health decline within 2 years of diagnosis for BC survivors receiving endocrine therapy (\u03b2\u2009=\u2009\u22121.12; 95% CI, \u22121.64 to \u22120.60), chemotherapy (\u03b2\u2009=\u2009\u22123.13; 95% CI, \u22124.19 to \u22122.07), or both (\u03b2\u2009=\u2009\u22123.26; 95% CI, \u22123.97 to \u22122.55). The decline among endocrine therapy users was restricted to women receiving aromatase inhibitors. More than 2 years after diagnosis, the decline was only observed in women who received chemotherapy.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of 15\u202f392 BC survivors and age-matched women without cancer, BC survivors who received chemotherapy had a long-lasting physical health decline, unlike survivors who received endocrine therapy without chemotherapy. Further studies are needed to confirm these results and to better understand the health consequences of these treatments.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.62365","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T11:33:28Z","timestamp":1740742408000},"page":"e2462365","source":"Crossref","is-referenced-by-count":17,"title":["Physical Health Decline After Chemotherapy or Endocrine Therapy in Breast Cancer Survivors"],"prefix":"10.1001","volume":"8","author":[{"given":"Clara","family":"Bodelon","sequence":"first","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Masters","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Den E","family":"Bloodworth","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Rees-Punia","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"},{"name":"Emory University Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpa V.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Teras","sequence":"additional","affiliation":[{"name":"Department of Population Science, American Cancer Society, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"issue":"5","key":"zoi241738r1","doi-asserted-by":"publisher","first-page":"363","DOI":"10.3322\/caac.21565","article-title":"Cancer treatment and survivorship statistics, 2019.","volume":"69","author":"Miller","year":"2019","journal-title":"CA Cancer J Clin"},{"issue":"5","key":"zoi241738r2","doi-asserted-by":"publisher","first-page":"409","DOI":"10.3322\/caac.21731","article-title":"Cancer treatment and survivorship statistics, 2022.","volume":"72","author":"Miller","year":"2022","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"zoi241738r3","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1093\/jnci\/dju335","article-title":"Psychosocial\/survivorship issues in breast cancer: are we doing better?","volume":"107","author":"Fallowfield","year":"2014","journal-title":"J Natl Cancer Inst"},{"issue":"12","key":"zoi241738r4","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1093\/jnci\/djy176","article-title":"Long-term survivorship care after cancer treatment\u2014summary of a 2017 national cancer policy forum workshop.","volume":"110","author":"Kline","year":"2018","journal-title":"J Natl Cancer Inst"},{"issue":"24","key":"zoi241738r5","doi-asserted-by":"publisher","first-page":"4333","DOI":"10.1002\/cncr.28376","article-title":"The symptom burden of cancer: Evidence for a core set of cancer-related and treatment-related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study.","volume":"119","author":"Cleeland","year":"2013","journal-title":"Cancer"},{"issue":"12","key":"zoi241738r6","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1093\/jnci\/djz136","article-title":"Measuring aging and identifying aging phenotypes in cancer survivors.","volume":"111","author":"Guida","year":"2019","journal-title":"J Natl Cancer Inst"},{"issue":"2","key":"zoi241738r7","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1200\/JCO.2016.67.1883","article-title":"Inflammatory cytokines and comorbidity development in breast cancer survivors versus noncancer controls: evidence for accelerated aging?","volume":"35","author":"Alfano","year":"2017","journal-title":"J Clin Oncol"},{"issue":"32","key":"zoi241738r8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00140","article-title":"Cancer-related cognitive outcomes among older breast cancer survivors in the thinking and living with cancer study.","volume":"36","author":"Mandelblatt","year":"2018","journal-title":"J Clin Oncol"},{"issue":"6","key":"zoi241738r9","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1002\/cncr.31238","article-title":"Fatigability and endurance performance in cancer survivors: analyses from the Baltimore Longitudinal Study of Aging.","volume":"124","author":"Gresham","year":"2018","journal-title":"Cancer"},{"issue":"9","key":"zoi241738r10","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.16747","article-title":"Association of prediagnostic frailty, change in frailty status, and mortality after cancer diagnosis in the women\u2019s health initiative.","volume":"3","author":"Cespedes Feliciano","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi241738r11","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1001\/jamaoncol.2022.6881","article-title":"Long-term trajectories of physical function decline in women with and without cancer.","volume":"9","author":"Cespedes Feliciano","year":"2023","journal-title":"JAMA Oncol"},{"issue":"1","key":"zoi241738r12","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s11764-012-0239-5","article-title":"Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women.","volume":"7","author":"Sehl","year":"2013","journal-title":"J Cancer Surviv"},{"issue":"6","key":"zoi241738r13","doi-asserted-by":"publisher","first-page":"524","DOI":"10.3322\/caac.21754","article-title":"Breast cancer statistics, 2022.","volume":"72","author":"Giaquinto","year":"2022","journal-title":"CA Cancer J Clin"},{"issue":"10","key":"zoi241738r14","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1093\/annonc\/mdi326","article-title":"Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005.","volume":"16","author":"Goldhirsch","year":"2005","journal-title":"Ann Oncol"},{"issue":"3","key":"zoi241738r15","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1002\/mco2.55","article-title":"Molecular mechanisms of chemo- and radiotherapy resistance and the potential implications for cancer treatment.","volume":"2","author":"Liu","year":"2021","journal-title":"MedComm (2020)"},{"issue":"1","key":"zoi241738r16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/cdd.2013.67","article-title":"Immune-based mechanisms of cytotoxic chemotherapy: implications for the design of novel and rationale-based combined treatments against cancer.","volume":"21","author":"Bracci","year":"2014","journal-title":"Cell Death Differ"},{"issue":"4","key":"zoi241738r17","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/j.ijrobp.2011.09.057","article-title":"High and low LET radiation differentially induce normal tissue damage signals.","volume":"83","author":"Niemantsverdriet","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"zoi241738r18","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.ccell.2020.03.009","article-title":"Overcoming endocrine resistance in breast cancer.","volume":"37","author":"Hanker","year":"2020","journal-title":"Cancer Cell"},{"issue":"2","key":"zoi241738r19","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1007\/s10549-022-06568-6","article-title":"Trajectories of objectively measured physical function among older breast cancer survivors in comparison with cancer-free controls.","volume":"193","author":"Luo","year":"2022","journal-title":"Breast Cancer Res Treat"},{"issue":"10","key":"zoi241738r20","doi-asserted-by":"publisher","first-page":"2296","DOI":"10.1002\/cncr.32757","article-title":"Health-related quality of life among breast cancer survivors and noncancer controls over 10 years: Pink SWAN.","volume":"126","author":"Avis","year":"2020","journal-title":"Cancer"},{"issue":"9","key":"zoi241738r21","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1200\/JCO.2010.28.8043","article-title":"Physical and psychosocial recovery in the year after primary treatment of breast cancer.","volume":"29","author":"Ganz","year":"2011","journal-title":"J Clin Oncol"},{"issue":"11","key":"zoi241738r22","doi-asserted-by":"publisher","first-page":"2014","DOI":"10.1002\/cncr.30561","article-title":"The American Cancer Society\u2019s Cancer Prevention Study 3 (CPS-3): recruitment, study design, and baseline characteristics.","volume":"123","author":"Patel","year":"2017","journal-title":"Cancer"},{"issue":"2","key":"zoi241738r23","doi-asserted-by":"publisher","first-page":"293","DOI":"10.2307\/2531050","article-title":"More on \u201cbiased selection of controls for case-control analyses of cohort studies\u201d.","volume":"42","author":"Robins","year":"1986","journal-title":"Biometrics"},{"issue":"7","key":"zoi241738r24","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1007\/s11136-009-9496-9","article-title":"Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items.","volume":"18","author":"Hays","year":"2009","journal-title":"Qual Life Res"},{"issue":"5","key":"zoi241738r26","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1111\/jgs.15493","article-title":"Functional decline and resilience in older women receiving adjuvant chemotherapy for breast cancer.","volume":"67","author":"Hurria","year":"2019","journal-title":"J Am Geriatr Soc"},{"issue":"43","key":"zoi241738r27","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_390442","article-title":"Advances in the management of menopausal symptoms, fertility preservation, and bone health for women with breast cancer on endocrine therapy.","volume":"43","author":"Lambertini","year":"2023","journal-title":"Am Soc Clin Oncol Educ Book"},{"issue":"7","key":"zoi241738r28","doi-asserted-by":"publisher","first-page":"e303","DOI":"10.1016\/S1470-2045(20)30666-5","article-title":"Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer.","volume":"22","author":"Franzoi","year":"2021","journal-title":"Lancet Oncol"},{"issue":"2","key":"zoi241738r29","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s10549-012-2114-5","article-title":"Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review.","volume":"134","author":"Murphy","year":"2012","journal-title":"Breast Cancer Res Treat"},{"key":"zoi241738r30","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.breast.2022.01.012","article-title":"Factors influencing five-year adherence to adjuvant endocrine therapy in breast cancer patients: a systematic review.","volume":"62","author":"Yussof","year":"2022","journal-title":"Breast"},{"issue":"3","key":"zoi241738r31","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s10549-015-3647-1","article-title":"Benefit\/risk for adjuvant breast cancer therapy with tamoxifen or aromatase inhibitor use by age, and race\/ethnicity.","volume":"154","author":"Chlebowski","year":"2015","journal-title":"Breast Cancer Res Treat"},{"issue":"3","key":"zoi241738r32","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1093\/annonc\/mdw673","article-title":"Cardiotoxicity of aromatase inhibitors and tamoxifen in postmenopausal women with breast cancer: a systematic review and meta-analysis of randomized controlled trials.","volume":"28","author":"Khosrow-Khavar","year":"2017","journal-title":"Ann Oncol"},{"issue":"16","key":"zoi241738r33","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1136\/heartjnl-2020-317510","article-title":"Endocrine therapy use and cardiovascular risk in postmenopausal breast cancer survivors.","volume":"107","author":"Matthews","year":"2021","journal-title":"Heart"},{"issue":"1","key":"zoi241738r34","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s13058-018-1061-4","article-title":"Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women: a prospective cohort study.","volume":"20","author":"Ramin","year":"2018","journal-title":"Breast Cancer Res"},{"issue":"5","key":"zoi241738r35","doi-asserted-by":"publisher","first-page":"GS1","DOI":"10.1158\/1538-7445.SABCS22-GS1-04","article-title":"Abstract GS1-04: patient-reported cognitive impairment in women participating in the RxPONDER trial (SWOG S1007) by menopausal status.","volume":"83","author":"Kang","year":"2023","journal-title":"Cancer Res"},{"issue":"7","key":"zoi241738r36","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.22493","article-title":"Alzheimer disease and related dementia following hormone-modulating therapy in patients with breast cancer.","volume":"7","author":"Cai","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"8","key":"zoi241738r37","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1200\/JCO.2015.64.3866","article-title":"Impact of adjuvant endocrine therapy on quality of life and symptoms: observational data over 12 months from the Mind-Body Study.","volume":"34","author":"Ganz","year":"2016","journal-title":"J Clin Oncol"},{"issue":"4","key":"zoi241738r38","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.amjsurg.2006.06.018","article-title":"Side effects of aromatase inhibitors versus tamoxifen: the patients\u2019 perspective.","volume":"192","author":"Garreau","year":"2006","journal-title":"Am J Surg"},{"issue":"2","key":"zoi241738r39","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.3390\/curroncol30020112","article-title":"Adherence to adjuvant endocrine therapy in breast cancer patients.","volume":"30","author":"Rosso","year":"2023","journal-title":"Curr Oncol"},{"issue":"4","key":"zoi241738r40","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1200\/JCO.23.02270","article-title":"Omission of radiotherapy after breast-conserving surgery for women with breast cancer with low clinical and genomic risk: 5-year outcomes of IDEA.","volume":"42","author":"Jagsi","year":"2024","journal-title":"J Clin Oncol"},{"issue":"19","key":"zoi241738r41","doi-asserted-by":"publisher","first-page":"4545","DOI":"10.3390\/cancers14194545","article-title":"De-escalating the management of in situ and invasive breast cancer.","volume":"14","author":"Angarita","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"8","key":"zoi241738r42","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1093\/annonc\/mdx308","article-title":"De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017.","volume":"28","author":"Curigliano","year":"2017","journal-title":"Ann Oncol"},{"issue":"1","key":"zoi241738r43","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/jcpt.12227","article-title":"Longitudinal trends in utilization of endocrine therapies for breast cancer: an international comparison.","volume":"40","author":"Kelly","year":"2015","journal-title":"J Clin Pharm Ther"},{"issue":"5","key":"zoi241738r44","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1200\/JCO.18.01160","article-title":"Adjuvant endocrine therapy for women with hormone receptor\u2013positive breast cancer: ASCO clinical practice guideline focused update.","volume":"37","author":"Burstein","year":"2019","journal-title":"J Clin Oncol"},{"key":"zoi241738r25","unstructured":"PROMIS. Global Health scoring manual. Accessed January 27, 2025. https:\/\/www.healthmeasures.net\/images\/PROMIS\/manuals\/Scoring_Manual_Only\/PROMIS_Global_Health_Scoring_Manual_22June2023.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2830797\/bodelon_2025_oi_241738_1740000104.63775.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T11:33:31Z","timestamp":1740742411000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2830797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":44,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.62365","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]}}}