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Breast cancer patients today can expect long-term survival; however, weight gain is a common problem after treatment and increases the risk for recurrence, cardiovascular disease and diabetes. The multi-ethnic cohort from the Cancer and Menopause Study, designed to examine the reproductive and late cardiovascular health effects of treatment in younger female breast cancer survivors (BCS), was used to describe the relationship of behavioral and treatment variables to body mass index (BMI), physical activity (PA), and cardiovascular risk factors.Stage 0, I or II breast cancer survivors who were ≤ 50 years at diagnosis and 2-10 years disease-free survivors (mean 5.9 ± 2.3 years) were recruited from two tumor registries to complete a mail survey that included information on demographics, health-related quality of life, reproductive health, cancer treatment, PA, weight and height. A sub-sample completed an office visit where fasting blood lipids, blood pressure (BP), height and weight were measured. Linear regression analysis was used to model the following outcomes: BMI, PA, blood lipids and BP.Current BMI was positively associated with higher BMI prior to diagnosis, unhappiness with body image and negatively associated with current total PA (model p < 0.001). More work, home and leisure PA were all positively associated with greater physical functioning and higher energy levels (all models, p < 0.001). Total and LDL cholesterol were positively associated with number of years since diagnosis and negatively associated with leisure PA (both models, p < 0.001), while systolic and diastolic BP were both positively associated with age, current use of BP medications and current BMI (models, p < 0.001).Obesity in these BCS is prevalent and associated with premorbid obesity and decreased current physical activity but not with adjuvant treatment. Given the negative health consequences of weight gain and obesity after breast cancer, continued study of the etiology of weight gain, and potential targets for weight gain prevention are required. Interventions that target PA may be important for weight maintenance in BCS.