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The influence of adjuvant therapy on cardiorespiratory fitness in early-stage breast cancer seven years after diagnosis: the Cooper Center Longitudinal Study

  • Epidemiology
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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.

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Abbreviations

CVD:

Cardiovascular disease

CCLS:

Cooper Center Longitudinal Study

METs:

Metabolic equivalents

LVEF:

Left ventricular ejection fraction

CRF:

Cardiorespiratory fitness

ECG:

Electrocardiogram

ANCOVA:

Analysis of covariance

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Acknowledgments

LWJ is supported in part by Research Grants from the National Cancer Institute (CA143254, CA142566, CA138634, CA133895, CA164751).

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Vermont Cancer Center, University of Vermont, Burlington, VT, USA

    Susan G. Lakoski

  2. The Cooper Institute, Dallas, TX, USA

    Carolyn E. Barlow, Jesse Hernandez, Laura F. DeFina & Nina B. Radford

  3. School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada

    Graeme J. Koelwyn

  4. Duke University Medical Center, Durham, NC, USA

    Whitney E. Hornsby, Samantha M. Thomas, James E. Herndon II, Jeffrey Peppercorn, Pamela S. Douglas & Lee W. Jones

Authors
  1. Susan G. Lakoski
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  2. Carolyn E. Barlow
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  3. Graeme J. Koelwyn
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  4. Whitney E. Hornsby
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  5. Jesse Hernandez
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  6. Laura F. DeFina
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  7. Nina B. Radford
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  8. Samantha M. Thomas
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  9. James E. Herndon II
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  10. Jeffrey Peppercorn
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  11. Pamela S. Douglas
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  12. Lee W. Jones
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Corresponding author

Correspondence to Lee W. Jones.

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Lakoski, S.G., Barlow, C.E., Koelwyn, G.J. et al. The influence of adjuvant therapy on cardiorespiratory fitness in early-stage breast cancer seven years after diagnosis: the Cooper Center Longitudinal Study. Breast Cancer Res Treat 138, 909–916 (2013). https://doi.org/10.1007/s10549-013-2478-1

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  • DOI: https://doi.org/10.1007/s10549-013-2478-1

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