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During follow-up, 574 women developed invasive breast cancer. Breast cancer cases were followed for an additional 9.1\u00a0years. Detailed medical records were obtained. Cox\u2019s 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.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>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\u00a0years, 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\u20135 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\u20133.69), and they were 3.4\u00a0years younger at diagnosis (64.8 versus 68.2\u00a0years, <jats:italic>P<\/jats:italic>\u2009=\u20090.032). Breast cancer patients with an unfavorable lifestyle, compared with patients with a favorable lifestyle, had almost a two times higher overall mortality risk (HR\u00a01.96, 95% CI\u00a01.01\u20133.80).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our study supports a healthy lifestyle improving breast cancer prevention, postponing onset of disease, and extending life expectancy among breast cancer patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s10549-020-05679-2","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T18:04:11Z","timestamp":1589997851000},"page":"215-227","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Exploring the effects of lifestyle on breast cancer risk, age at diagnosis, and survival: the EBBA-Life study"],"prefix":"10.1007","volume":"182","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6019-3305","authenticated-orcid":false,"given":"Trygve","family":"Lofter\u00f8d","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Frydenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidar","family":"Flote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Elise","family":"Eggen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"McTiernan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin S.","family":"Mortensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars A.","family":"Akslen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon B.","family":"Reitan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Wilsgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Thune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"5679_CR1","doi-asserted-by":"publisher","DOI":"10.14694\/EdBook_AM.2015.35.e66","author":"M Harvie","year":"2015","unstructured":"Harvie M, Howell A, Evans DG (2015) Can diet and lifestyle prevent breast cancer: what is the evidence? 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