title: The influence of adjuvant therapy on cardiorespiratory fitness in early-stage breast cancer seven years after diagnosis: the Cooper Center Longitudinal Study.
abstract: We examined cardiorespiratory fitness (CRF) levels in early stage breast cancer patients and determined whether CRF differs as a function of adjuvant therapy regimen. A total of 180 early breast cancer patients representing three treatment groups (surgery only, single-, and multi-modality adjuvant therapy) in the Cooper Center Longitudinal Study (CCLS) were studied. A non-cancer control group (n = 180) matched by sex, age, and date of the CCLS visit was included. All subjects underwent an incremental exercise tolerance test to symptom limitation to assess CRF (i.e., peak metabolic equivalents [METs] and time to exhaustion). The mean time from breast cancer diagnosis to exercise tolerance testing was 7.4 ± 6.2 years. In adjusted analyses, time to exhaustion and peak METs were incrementally impaired with the addition of surgery, single-, and multi-modality adjuvant therapy compared to those of matched controls (p = 0.006 and 0.028, respectively). CRF was lowest in the multi-modality group compared to all other groups (all p's < 0.05). Despite being 7 years post-diagnosis, asymptomatic early breast cancer survivors have marked reductions in CRF. Patients treated with multi-modal adjuvant therapy have the greatest impairment in CRF.
authors.affiliation: Division of Hematology/Oncology, Vermont Cancer Center, University of Vermont, Burlington, VT, USA. susan.lakoski@uvm.edu
authors.forename: Susan G
authors.initials: SG
authors.lastname: Lakoski
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Barlow
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Koelwyn
authors.forename: Whitney E
authors.initials: WE
authors.lastname: Hornsby
authors.forename: Jesse
authors.initials: J
authors.lastname: Hernandez
authors.forename: Laura F
authors.initials: LF
authors.lastname: Defina
authors.forename: Nina B
authors.initials: NB
authors.lastname: Radford
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Thomas
authors.forename: James E
authors.initials: JE
authors.lastname: Herndon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Peppercorn
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Douglas
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects / Q000528:radiation effects; D016022:Case-Control Studies; D003131:Combined Modality Therapy / Q000009:adverse effects*; D005080:Exercise Test; D017079:Exercise Tolerance; D005221:Fatigue; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008408:Mastectomy; D008875:Middle Aged; D010809:Physical Fitness; D011446:Prospective Studies; D017741:Survivors