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Kresovich JK, O’Brien KM, Xu Z, Weinberg CR, Sandler DP, Taylor JA. Circulating Leukocyte Subsets Before and After a Breast Cancer Diagnosis and Therapy. JAMA Netw Open 2024; 7:e2356113. [PMID: 38358741 PMCID: PMC10870180 DOI: 10.1001/jamanetworkopen.2023.56113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024] Open
Abstract
Importance Changes in leukocyte composition often precede chronic disease onset. Patients with a history of breast cancer (hereinafter referred to as breast cancer survivors) are at increased risk for subsequent chronic diseases, but the long-term changes in peripheral leukocyte composition following a breast cancer diagnosis and treatment remain unknown. Objective To examine longitudinal changes in peripheral leukocyte composition in women who did and did not develop breast cancer and identify whether differences in breast cancer survivors were associated with specific treatments. Design, Setting, and Participants In this prospective cohort study, paired blood samples were collected from 2315 women enrolled in The Sister Study, a US-nationwide prospective cohort study of 50 884 women, at baseline (July 2003 to March 2009) and follow-up (October 2013 to March 2015) home visits, with a mean (SD) follow-up interval of 7.6 (1.4) years. By design, approximately half of the included women had been diagnosed and treated for breast cancer after enrollment and before the second blood draw. A total of 410 women were included in the present study, including 185 breast cancer survivors and 225 who remained free of breast cancer over a comparable follow-up period. Data were analyzed from April 21 to September 9, 2022. Exposures Breast cancer status and, among breast cancer survivors, cancer treatment type (chemotherapy, radiotherapy, endocrine therapy, or surgery). Main Outcomes and Measures Blood DNA methylation data were generated in 2019 using a genome-wide methylation screening tool and deconvolved to estimate percentages of 12 circulating leukocyte subsets. Results Of the 410 women included in the analysis, the mean (SD) age at enrollment was 56 (9) years. Compared with breast cancer-free women, breast cancer survivors had decreased percentages of circulating eosinophils (-0.45% [95% CI, -0.87% to -0.03%]; P = .03), total CD4+ helper T cells (-1.50% [95% CI, -2.56% to -0.44%]; P = .01), and memory B cells (-0.22% [95% CI, -0.34% to -0.09%]; P = .001) and increased percentages of circulating naive B cells (0.46% [95% CI, 0.17%-0.75%]; P = .002). In breast cancer survivor-only analyses, radiotherapy was associated with decreases in total CD4+ T cell levels, whereas chemotherapy was associated with increases in naive B cell levels. Surgery and endocrine therapy were not meaningfully associated with leukocyte changes. Conclusions and Relevance In this cohort study of 410 women, breast cancer survivors experienced lasting changes in peripheral leukocyte composition compared with women who remained free of breast cancer. These changes may be related to treatment with chemotherapy or radiotherapy and could influence future chronic disease risk.
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Affiliation(s)
- Jacob K. Kresovich
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Department of Breast Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
| | - Katie M. O’Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
| | - Zongli Xu
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
| | - Clarice R. Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
| | - Jack A. Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina
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Kresovich JK, O’Brien KM, Xu Z, Weinberg CR, Sandler DP, Taylor JA. Changes in methylation-based aging in women who do and do not develop breast cancer. J Natl Cancer Inst 2023; 115:1329-1336. [PMID: 37467056 PMCID: PMC10637033 DOI: 10.1093/jnci/djad117] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Breast cancer survivors have increased incidence of age-related diseases, suggesting that some survivors may experience faster biological aging. METHODS Among 417 women enrolled in the prospective Sister Study cohort, DNA methylation data were generated on paired blood samples collected an average of 7.7 years apart and used to calculate 3 epigenetic metrics of biological aging (PhenoAgeAccel, GrimAgeAccel, and Dunedin Pace of Aging Calculated from the Epigenome [DunedinPACE]). Approximately half (n = 190) the women sampled were diagnosed and treated for breast cancer between blood draws, whereas the other half (n = 227) remained breast cancer-free. Breast tumor characteristics and treatment information were abstracted from medical records. RESULTS Among women who developed breast cancer, diagnoses occurred an average of 3.5 years after the initial blood draw and 4 years before the second draw. After accounting for covariates and biological aging metrics measured at baseline, women diagnosed and treated for breast cancer had higher biological aging at the second blood draw than women who remained cancer-free as measured by PhenoAgeAccel (standardized mean difference [β] = 0.13, 95% confidence interval [CI) = 0.00 to 0.26), GrimAgeAccel (β = 0.14, 95% CI = 0.03 to 0.25), and DunedinPACE (β = 0.37, 95% CI = 0.24 to 0.50). In case-only analyses assessing associations with different breast cancer therapies, radiation had strong positive associations with biological aging (PhenoAgeAccel: β = 0.39, 95% CI = 0.19 to 0.59; GrimAgeAccel: β = 0.29, 95% CI = 0.10 to 0.47; DunedinPACE: β = 0.25, 95% CI = 0.02 to 0.48). CONCLUSIONS Biological aging is accelerated following a breast cancer diagnosis and treatment. Breast cancer treatment modalities appear to differentially contribute to biological aging.
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Affiliation(s)
- Jacob K Kresovich
- Departments of Cancer Epidemiology & Breast Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Katie M O’Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Zongli Xu
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
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Wagoner CW, Friedenreich CM, Courneya KS, Wang Q, Vallance JK, Matthews CE, Yang L, McNeely ML, Bell GJ, Morielli AR, McNeil J, Dickau L, Culos-Reed SN. Social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in newly diagnosed women with breast cancer. Support Care Cancer 2023; 31:537. [PMID: 37624525 DOI: 10.1007/s00520-023-08001-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Identifying correlates of physical activity and sedentary behaviour allows for the identification of factors that may be targeted in future behaviour change interventions. This study sought to determine the social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in individuals recently diagnosed with breast cancer. METHODS Data were collected from 1381 participants within 90 days of diagnosis in the Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study. Physical activity and sedentary behaviour were measured with ActiGraph GT3X+® and activPALTM devices, respectively, for seven consecutive days. Correlates were collected via a self-reported questionnaire, medical record extraction, or measured by staff. RESULTS Multivariable models were fitted for sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity. Greater sedentary behaviour was associated with higher body fat percentage (BF%) (ß=0.044; p<0.001) and being single (ß=0.542; p<0.002). Lower light physical activity was associated with higher BF% (ß=-0.044; p<0.001), higher body mass index (ß=-0.039; p<0.001), greater disease barrier influence (ß=-0.006; p<0.001), a HER2-positive diagnosis (ß=-0.278; p=0.001), and being single (ß=-0.385; p= 0.001). Lower moderate-to-vigorous physical activity was associated with higher BF% (ß =-0.011; p=0.001), greater disease barrier influence (ß=-0.002; p<0.001), and being of Asian (ß=-0.189; p=0.002) or Indian/South American (ß=-0.189; p=0.002) descent. Greater moderate-to-vigorous physical activity was associated with having greater intentions (ß=0.049; p=0.033) and planning (ß=0.026; p=0.015) towards physical activity. CONCLUSION Tailoring interventions to increase physical activity for individuals recently diagnosed with breast cancer may improve long-term outcomes across the breast cancer continuum.
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Affiliation(s)
- Chad W Wagoner
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada.
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Gordon J Bell
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - Jessica McNeil
- Department of Kinesiology, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, USA
| | - Leanne Dickau
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Edmonton, Canada
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Huot JR, Baumfalk D, Resendiz A, Bonetto A, Smuder AJ, Penna F. Targeting Mitochondria and Oxidative Stress in Cancer- and Chemotherapy-Induced Muscle Wasting. Antioxid Redox Signal 2023; 38:352-370. [PMID: 36310444 PMCID: PMC10081727 DOI: 10.1089/ars.2022.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/04/2022] [Accepted: 10/22/2022] [Indexed: 12/31/2022]
Abstract
Significance: Cancer is frequently associated with the early appearance of cachexia, a multifactorial wasting syndrome. If not present at diagnosis, cachexia develops either as a result of tumor progression or as a side effect of anticancer treatments, especially of standard chemotherapy, eventually representing the direct cause of death in up to one-third of all cancer patients. Cachexia, within its multiorgan affection, is characterized by severe loss of muscle mass and function, representing the most relevant subject of preclinical and clinical investigation. Recent Advances: The pathogenesis of muscle wasting in cancer- and chemotherapy-induced cachexia is complex, and encompasses heightened protein catabolism and reduced anabolism, disrupted mitochondria and energy metabolism, and even neuromuscular junction dismantling. The mechanisms underlying these alterations are still controversial, especially concerning the molecular drivers that could be targeted for anticachexia therapies. Inflammation and mitochondrial oxidative stress are among the principal candidates; the latter being extensively discussed in the present review. Critical Issues: Several approaches have been tested to modulate the redox homeostasis in tumor hosts, and to counteract cancer- and chemotherapy-induced muscle wasting, from exercise training to distinct classes of direct or indirect antioxidants. We herein report the most relevant results obtained from both preclinical and clinical trials. Future Directions: Including the assessment and the treatment of altered redox balance in the clinical management of cancer patients is still a big challenge. The available evidence suggests that fortifying the antioxidant defenses by either pharmacological or nonpharmacological strategies will likely improve cachexia and eventually the outcome of a broad cancer patient population. Antioxid. Redox Signal. 38, 352-370.
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Affiliation(s)
- Joshua R. Huot
- Department of Surgery and Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dryden Baumfalk
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - Aridai Resendiz
- Department of Oncology, Surgical Oncology and Digestive Surgery Unit, S Luigi University Hospital, University of Torino, Torino, Italy
| | - Andrea Bonetto
- Department of Surgery and Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Otolaryngology–Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Center for Musculoskeletal Health, and Indiana University School of Medicine, Indianapolis, Indiana, USA
- Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ashley J. Smuder
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - Fabio Penna
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
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Kokkonen K, Kellokumpu-Lehtinen PL, Kankaanpää M, Nikander R, Penttinen HM, Utriainen M, Vehmanen L, Huovinen R, Kautiainen H, Blomqvist C, Saarto T. Factors predicting long-term physical activity of breast cancer survivors. 5-year-follow-up of the BREX exercise intervention study. Acta Oncol 2022; 61:1200-1208. [PMID: 35881067 DOI: 10.1080/0284186x.2022.2103388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The benefits of exercise training are well documented among breast cancer (BC) survivors. Patients decrease their physical activity during treatment, and many fail to regain their previous exercise levels. There is therefore a need to define factors supporting long-term physical activity behavior in this patient group, to target supporting interventions aimed at preventing the decline in physical activity (PA). AIM The aim of this study was to determine physical and psychosocial factors explaining long-term physical activity after the adjuvant treatments in BC survivors. METHODS Four-hundred forty-six BC survivors followed for 5-years within a randomized exercise trial participated. Factors explaining (1) physical activity after the adjuvant treatments and (2) changes in physical activity in long-term were analyzed using linear regression models and general estimating equation models. Pretreatment leisure-time physical activity (LTPA), demographic, and treatment factors, physical fitness, and quality of life (Qol) at baseline were independent factors. RESULTS Exercise levels increased during the first year, and thereafter remained mostly stable. Higher LTPA, higher fitness level, better Qol and older age at baseline were associated with higher physical activity level after adjuvant treatments (p < .001) in multivariate analysis. Higher levels of fatigue (p < .008) and better emotional functioning (p = .017) at baseline were the main factors associated with increased physical activity during the follow-up. CONCLUSION Previous exercise habits and Qol after adjuvant chemo-, and radiotherapy were the strongest determinants of long-term physical activity levels in breast cancer survivors. Patients with better emotional functioning increased their exercise activity most as did those patients with higher fatigue levels at baseline. Patients suffering from fatigue after adjuvant treatment managed to increase their exercise levels, in contrast to patients with low emotional functioning, and may benefit from physical exercise interventions. Emotionally deprived patients may benefit from psychosocial support to regain their previous exercise levels.
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Affiliation(s)
| | | | - Markku Kankaanpää
- Department of Physiatry and Rehabilitation Medicine, Tampere University Hospital, Tampere, Finland
| | - Riku Nikander
- Faculty of Sport and Health Sciences, University of Jyväskylä; Central Finland Health Care District; GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland
| | | | - Meri Utriainen
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Leena Vehmanen
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Riikka Huovinen
- Turku University Hospital, Department of Oncology, University of Turku, Faculty of Medicine, Turku, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Finland and Folkhälsan Research Center, Helsinki, Finland
| | - Carl Blomqvist
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Tiina Saarto
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
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Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14082026. [PMID: 35454932 PMCID: PMC9032592 DOI: 10.3390/cancers14082026] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although cancer survivors may experience health benefits from favorable lifestyle changes, many cancer survivors do not adhere to lifestyle recommendations or make favorable lifestyle changes after cancer diagnosis. This systematic review of the literature aimed to provide an overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. It provides a structured overview of the large variety of determinants of changes in different lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) derived from the 123 included papers (71 quantitative and 52 qualitative). Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors and inform researchers and healthcare professionals about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Abstract The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.
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Di Blasio A, Di Dalmazi G, Morano T, Bucci I, Verrocchio S, Grossi S, Cianchetti E, Valentini P, Cugusi L, Gobbo S, Bergamin M, Grassadonia A, Napolitano G. Relationships between daily physical activity combinations and psychophysical health status of Italian breast cancer survivors. Home Health Care Serv Q 2022; 41:200-218. [PMID: 35184693 DOI: 10.1080/01621424.2022.2041524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In breast cancer survivors (BCS), the contemporaneous increase of sedentary time and reduction of physical activity (PA) requires early attention because it has negative consequences for their health. Aims of the study were to investigate: a) the correlations between PA, sedentarism, and health-related measures; b) the association between different patterns of daily activity and health-related outcomes. Two hundred and nineteen BCS (50.98 ± 6.28) were selected for this study. Psychological, anthropometric, endocrine, sleeping, and both daily sedentary time and PA variables were considered. Sedentarism and PA have opposite correlations with anthropometric variables, anxiety, depression, morning salivary cortisol, and sleeping characteristics. The first favors pathological values and the latter favors normal values. Regression tree analysis showed the impact of different daily sedentary time and PA combinations on the investigated variables and allowed the individualization of their optimal combination for health. Our results could be useful to healthcare providers and BCS.
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Affiliation(s)
- Andrea Di Blasio
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giulia Di Dalmazi
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Teresa Morano
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Ines Bucci
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Sara Verrocchio
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Simona Grossi
- Eusoma Breast Center, "G. Bernabeo" Hospital, Ortona, Italy
| | | | - Pasquale Valentini
- Department of Economics, "G. d'Annunzio" University of Chieti-Pescara, Pescara, Italy
| | - Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Stefano Gobbo
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Marco Bergamin
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Antonino Grassadonia
- Department of Innovative Technologies in Medicine and Dentistry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Beeren I, de Goeij L, Dandis R, Vidra N, van Zutphen M, Witjes JA, Kampman E, Kiemeney LALM, Vrieling A. Limited Changes in Lifestyle Behaviours after Non-Muscle Invasive Bladder Cancer Diagnosis. Cancers (Basel) 2022; 14:cancers14040960. [PMID: 35205711 PMCID: PMC8869990 DOI: 10.3390/cancers14040960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/04/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was to investigate adherence to lifestyle recommendations and lifestyle changes after diagnosis in patients with non-muscle invasive bladder cancer (NMIBC). Second, we aimed to identify distinct trajectories of lifestyle change and their correlates. We analysed data of 935 patients with NMIBC from a prospective cohort study at six weeks (evaluating pre-diagnostic lifestyle), three months, and fifteen months after diagnosis. An overall lifestyle score (range 0-7) was calculated based on the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations focusing on diet, body mass index, and physical activity. Linear mixed models were used to analyse absolute lifestyle changes over time. Distinct trajectories of change were identified with latent class trajectory models. We found an overall lifestyle score of 3.3 which remained constant over time. The largest lifestyle changes were observed for the consumption of red and processed meat (-96 g/week) and fruit and vegetables (-38 g/day). Two to four trajectory groups were identified for each single lifestyle behaviour. Correlates differed per trajectory group. In conclusion, adherence to the WCRF/AICR recommendations was low. Small to moderate changes in and different trajectories of single lifestyle behaviours were observed. Effective strategies for lifestyle improvement are warranted.
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Affiliation(s)
- Ivy Beeren
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
| | - Liesbeth de Goeij
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
| | - Rana Dandis
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
| | - Nikoletta Vidra
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
| | - Moniek van Zutphen
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
| | - J. Alfred Witjes
- Department of Urology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The Netherlands;
| | - Lambertus A. L. M. Kiemeney
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
- Department of Urology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Alina Vrieling
- Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (I.B.); (L.d.G.); (R.D.); (N.V.); (M.v.Z.); (L.A.L.M.K.)
- Correspondence: ; Tel.: +31-24-3616944
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Doré I, Plante A, Peck SS, Bedrossian N, Sabiston CM. Physical activity and sedentary time: associations with fatigue, pain, and depressive symptoms over 4 years post-treatment among breast cancer survivors. Support Care Cancer 2022. [PMID: 34387728 DOI: 10.1007/s00520-021-06469-2/tables/3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Despite the recommendations for cancer survivors to engage in physical activity (PA), little is known about the effects of both PA and sedentary time (ST) on key health symptoms. This study prospectively examined the lifestyle behaviors of moderate-to-vigorous PA (MVPA) and ST as predictors of depressive symptoms, pain, and fatigue in breast cancer survivors using longitudinal data from early post-treatment to 4-year survivorship. METHODS Breast cancer survivors (n = 199, mean(SD) age = 55.0(11.0) years) self-reported depressive symptoms, pain, and fatigue, and wore an accelerometer to measure MVPA and ST every 3 months during the first year (times 1 to 5) and 2 and 4 years (times 6 and 8) post-cancer treatment. Linear mixed models were adjusted for personal (e.g., age, BMI, education) and cancer (e.g., stage, time since treatment) variables. RESULTS MVPA and ST were independent predictors of depressive symptoms, but not fatigue, and only ST was associated with pain over 4 years post-treatment. Higher levels of MVPA were associated with lower scores of depressive symptoms ([Formula: see text] (95%CI): - 0.062 (- 0.092, - 0.031) p < .001), whereas higher levels of ST were associated with higher scores of depressive symptoms ([Formula: see text] (95%CI): 0.023 (0.017, 0.028) p < .001). Higher levels of ST were associated with increased pain level over time ([Formula: see text] (95%CI): 0.017 (0.007, 0.027) p = .001). CONCLUSIONS Rehabilitation interventions should aim to both increase MVPA and reduce ST to promote health and well-being among breast cancer survivors, in particular during the early post-treatment period.
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Affiliation(s)
- Isabelle Doré
- Scool of Komnesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, 2100, boulevard Édouard-Montpetit, Montreal, Québec, H3T 1J4, Canada.
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, (CRCHUM), Montreal, Canada.
- School of Public Health, Université de Montréal, Montreal, Canada.
| | - Audrey Plante
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, (CRCHUM), Montreal, Canada
- School of Public Health, Université de Montréal, Montreal, Canada
| | - Serena S Peck
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Nathalie Bedrossian
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, (CRCHUM), Montreal, Canada
- School of Public Health, Université de Montréal, Montreal, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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10
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Di Meglio A, Soldato D, Presti D, Vaz-Luis I. Lifestyle and quality of life in patients with early-stage breast cancer receiving adjuvant endocrine therapy. Curr Opin Oncol 2021; 33:553-573. [PMID: 34456250 DOI: 10.1097/cco.0000000000000781] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW A comprehensive approach to survivorship care for women with early-stage, hormone-receptor positive breast cancer should systematically include the proactive assessment and adequate management of endocrine therapy-associated symptoms, in order to assure optimal balance between preserving quality of life (QOL) and maximizing treatment adherence. We reviewed the recent literature focused on lifestyle factors, including physical activity, diet and nutrition, weight management, smoke, and alcohol behavior, and their link with symptomatology and QOL among women receiving adjuvant endocrine therapy. RECENT FINDINGS Recent studies confirm the safety, feasibility, and effectiveness of lifestyle interventions in mitigating several common endocrine therapy-related effects, including musculoskeletal pain, fatigue, and insomnia, and in improving physical and emotional wellbeing as well as overall health-related QOL among women with early-stage breast cancer. SUMMARY Healthy lifestyle behaviors have the potential to modulate the downstream impact of endocrine therapy and improve QOL among women with early-stage breast cancer. Considerations for real-world clinical care implementation emerged, including a need to evaluate the long-term uptake of healthy behaviors and facilitate the postintervention maintenance of an improved lifestyle. Some facilitators to health promotion in breast cancer survivors were also suggested, such as individualized and one-to-one supervised programs, and digital solutions providing real-time feedback, building on personalized, direct patient engagement.
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Affiliation(s)
- Antonio Di Meglio
- Molecular predictors and new targets in oncology, INSERM Unit 981, Gustave Roussy, Villejuif
| | - Davide Soldato
- Molecular predictors and new targets in oncology, INSERM Unit 981, Gustave Roussy, Villejuif.,Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova
| | - Daniele Presti
- Molecular predictors and new targets in oncology, INSERM Unit 981, Gustave Roussy, Villejuif.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Ines Vaz-Luis
- Molecular predictors and new targets in oncology, INSERM Unit 981, Gustave Roussy, Villejuif
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Doré I, Plante A, Peck SS, Bedrossian N, Sabiston CM. Physical activity and sedentary time: associations with fatigue, pain, and depressive symptoms over 4 years post-treatment among breast cancer survivors. Support Care Cancer 2021; 30:785-792. [PMID: 34387728 DOI: 10.1007/s00520-021-06469-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 07/25/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite the recommendations for cancer survivors to engage in physical activity (PA), little is known about the effects of both PA and sedentary time (ST) on key health symptoms. This study prospectively examined the lifestyle behaviors of moderate-to-vigorous PA (MVPA) and ST as predictors of depressive symptoms, pain, and fatigue in breast cancer survivors using longitudinal data from early post-treatment to 4-year survivorship. METHODS Breast cancer survivors (n = 199, mean(SD) age = 55.0(11.0) years) self-reported depressive symptoms, pain, and fatigue, and wore an accelerometer to measure MVPA and ST every 3 months during the first year (times 1 to 5) and 2 and 4 years (times 6 and 8) post-cancer treatment. Linear mixed models were adjusted for personal (e.g., age, BMI, education) and cancer (e.g., stage, time since treatment) variables. RESULTS MVPA and ST were independent predictors of depressive symptoms, but not fatigue, and only ST was associated with pain over 4 years post-treatment. Higher levels of MVPA were associated with lower scores of depressive symptoms ([Formula: see text] (95%CI): - 0.062 (- 0.092, - 0.031) p < .001), whereas higher levels of ST were associated with higher scores of depressive symptoms ([Formula: see text] (95%CI): 0.023 (0.017, 0.028) p < .001). Higher levels of ST were associated with increased pain level over time ([Formula: see text] (95%CI): 0.017 (0.007, 0.027) p = .001). CONCLUSIONS Rehabilitation interventions should aim to both increase MVPA and reduce ST to promote health and well-being among breast cancer survivors, in particular during the early post-treatment period.
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Affiliation(s)
- Isabelle Doré
- Scool of Komnesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, 2100, boulevard Édouard-Montpetit, Montreal, Québec, H3T 1J4, Canada. .,Centre de Recherche du Centre Hospitalier de l'Université de Montréal, (CRCHUM), Montreal, Canada. .,School of Public Health, Université de Montréal, Montreal, Canada.
| | - Audrey Plante
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, (CRCHUM), Montreal, Canada.,School of Public Health, Université de Montréal, Montreal, Canada
| | - Serena S Peck
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Nathalie Bedrossian
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, (CRCHUM), Montreal, Canada.,School of Public Health, Université de Montréal, Montreal, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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Strandberg E, Vassbakk-Svindland K, Henriksson A, Johansson B, Vikmoen O, Kudrén D, Schauer T, Lindman H, Wärnberg F, Berntsen S, Demmelmaier I, Nordin K, Raastad T. Effects of heavy-load resistance training during (neo-)adjuvant chemotherapy on muscle cellular outcomes in women with breast cancer. Medicine (Baltimore) 2021; 100:e24960. [PMID: 33725859 PMCID: PMC7969308 DOI: 10.1097/md.0000000000024960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION (Neo-)adjuvant chemotherapy for breast cancer has a deleterious impact on muscle tissue resulting in reduced cardiorespiratory fitness, skeletal muscle mass and function. Physical exercise during treatment may counteract some of these negative effects. However, the effects of resistance training (RT) alone have never been explored. The present study aims to investigate if heavy-load RT during (neo-)adjuvant chemotherapy counteracts deleterious effects on skeletal muscle in women diagnosed with breast cancer. We hypothesize that (neo-)adjuvant treatment with chemotherapy will reduce muscle fiber size, impair mitochondrial function, and increase indicators of cellular stress and that RT during treatment will counteract these negative effects. We also hypothesize that RT during (neo-)adjuvant chemotherapy will increase muscle and blood levels of potential antitumor myokines and reduce treatment-related side effects on muscle strength and cardiorespiratory fitness. METHODS Fifty women recently diagnosed with breast cancer scheduled to start (neo-)adjuvant chemotherapy will be randomized to either randomized to either intervention group or to control group.The intervention group will perform supervised heavy-load RT twice a week over the course of chemotherapy (approximately 16-weeks) whereas the control group will be encouraged to continue with their usual activities. Muscle biopsies from m. vastus lateralis will be collected before the first cycle of chemotherapy (T0), after chemotherapy (T1), and 6 months later (T2) for assessment of muscle cellular outcomes. The primary outcome for this study is muscle fiber size. Secondary outcomes are: regulators of muscle fiber size and function, indicators of cellular stress and mitochondrial function, myokines with potential antitumor effects, muscle strength, and cardiorespiratory fitness. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Regional Ethical Review Board in Uppsala, Sweden (Dnr:2016/230/2). Results will be disseminated through presentations at scientific meetings, publications in peer-reviewed journals, social media, and patient organizations. TRIAL REGISTRATION NUMBER NCT04586517.
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Affiliation(s)
| | | | | | - Birgitta Johansson
- Department of Public Health and Caring Sciences
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Olav Vikmoen
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | - David Kudrén
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Tim Schauer
- Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Lindman
- Department of Oncology, Uppsala University Hospital, Uppsala
| | - Fredrik Wärnberg
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sveinung Berntsen
- Department of Public Health and Caring Sciences
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | | | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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13
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Wakim NI, Braun TM, Kaye JA, Dodge HH. Choosing the right time granularity for analysis of digital biomarker trajectories. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12094. [PMID: 33354618 PMCID: PMC7748028 DOI: 10.1002/trc2.12094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/25/2020] [Accepted: 09/11/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The use of digital biomarker data in dementia research provides the opportunity for frequent cognitive and functional assessments that was not previously available using conventional approaches. Assessing high-frequency digital biomarker data can potentially increase the opportunities for early detection of cognitive and functional decline because of improved precision of person-specific trajectories. However, we often face a decision to condense time-stamped data into a coarser time granularity, defined as the frequency at which measurements are observed or summarized, for statistical analyses. It is important to find a balance between ease of analysis by condensing data and the integrity of the data, which is reflected in a chosen time granularity. METHODS In this paper, we discuss factors that need to be considered when faced with a time granularity decision. These factors include follow-up time, variables of interest, pattern detection, and signal-to-noise ratio. RESULTS We applied our procedure to real-world data which include longitudinal in-home monitored walking speed. The example shed lights on typical problems that data present and how we could use the above factors in exploratory analysis to choose an appropriate time granularity. DISCUSSION Further work is required to explore issues with missing data and computational efficiency.
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Affiliation(s)
- Nicole I. Wakim
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | - Thomas M. Braun
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | - Jeffrey A. Kaye
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
- Oregon Center for Aging and Technology (ORCATECH)Oregon Health & Science UniversityPortlandOregonUSA
| | - Hiroko H. Dodge
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
- Oregon Center for Aging and Technology (ORCATECH)Oregon Health & Science UniversityPortlandOregonUSA
| | - for ORCATECH
- Oregon Center for Aging and Technology (ORCATECH)Oregon Health & Science UniversityPortlandOregonUSA
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14
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Lopez P, Galvão DA, Taaffe DR, Newton RU, Souza G, Trajano GS, Pinto RS. Resistance training in breast cancer patients undergoing primary treatment: a systematic review and meta-regression of exercise dosage. Breast Cancer 2020; 28:16-24. [PMID: 32815096 DOI: 10.1007/s12282-020-01147-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/12/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Exercise is recognised as an adjunct therapy for breast cancer patients; however, little is known about the resistance training dose-response. We conducted a systematic review and meta-regression to examine the resistance training dose-response (i.e., volume and intensity) in breast cancer patients undergoing primary treatment. METHODS Searches in MEDLINE, CINAHL, and SPORTDiscus were conducted for studies published up to November 2019. Experimental studies that evaluated resistance-based exercise interventions in women with breast cancer undergoing primary treatment were included. Information about resistance training components, average change and change per week, as well as standardised mean difference were extracted, and used for meta-regression analysis. Outcome measures were upper and lower body muscle strength and body composition. RESULTS 10 trials were included in the systematic review and 4 trials in the dose-response analysis. Resistance training weekly prescribed volume was inversely associated with increases in upper and lower body muscle strength (r2 = 98.1-100%; p = 0.009), although there was no relationship between resistance training intensity and strength gains. There was insufficient data for the dose-response analysis of body mass index, percent body fat, and lean mass. CONCLUSION Low volume resistance training might be a suitable exercise recommendation for breast cancer patients undergoing primary treatment producing superior benefits for muscle strength compared to higher volume training, regardless of the training intensity. Low volume resistance training may provide a conservative and appropriate approach for breast cancer patients, allowing gradual progression and modification throughout the exercise program.
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Affiliation(s)
- Pedro Lopez
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia. .,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Giovani Souza
- Exercise Research Laboratory, Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ronei S Pinto
- Exercise Research Laboratory, Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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