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Exercise as a diagnostic and therapeutic tool for preventing cardiovascular morbidity in breast cancer patients– the BReast cancer EXercise InTervention (BREXIT) trial protocol

Authors
  • Foulkes, Stephen J.1, 2
  • Howden, Erin J.1
  • Antill, Yoland3, 4
  • Loi, Sherene5
  • Salim, Agus6, 7
  • Haykowsky, Mark J.1, 8
  • Daly, Robin M.2
  • Fraser, Steve F.2
  • La Gerche, Andre1, 9
  • 1 Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia , Melbourne (Australia)
  • 2 Deakin University, Geelong, VIC, Australia , Geelong (Australia)
  • 3 Melbourne Cancer Care, Cabrini Health, Brighton, VIC, Australia , Brighton (Australia)
  • 4 Monash University, Melbourne, VIC, Australia , Melbourne (Australia)
  • 5 Peter MacCallum Cancer Centre, Melbourne, VIC, Australia , Melbourne (Australia)
  • 6 Baker Heart and Diabetes Institute, Melbourne, VIC, Australia , Melbourne (Australia)
  • 7 The University of Melbourne, Melbourne, VIC, Australia , Melbourne (Australia)
  • 8 University of Alberta, Edmonton, AB, Canada , Edmonton (Canada)
  • 9 St Vincent’s Hospital Melbourne, Melbourne, VIC, Australia , Melbourne (Australia)
Type
Published Article
Journal
BMC Cancer
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jul 14, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12885-020-07123-6
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundAnthracycline chemotherapy (AC) is an efficacious (neo) adjuvant treatment for early-stage breast cancer (BCa), but is associated with an increased risk of cardiac dysfunction and functional disability. Observations suggest that regular exercise may be a useful therapy for the prevention of cardiovascular morbidity but it is yet to be interrogated in a large randomised trial.The primary aims of this study are to: 1) determine if 12-months of ET commenced at the onset of AC can reduce the proportion of BCa patients with functional disability (peak VO2, < 18 ml/kg/min), and 2) compare current standard-of-care for detecting cardiac dysfunction (resting left-ventricular ejection fraction assessed from 3-dimensional echocardiography) to measures of cardiac reserve (peak exercise cardiac output assessed from exercise cardiac magnetic resonance imaging) for predicting the development of functional disability 12-months following AC. Secondary aims are to assess the effects of ET on VO2peak, left ventricular morphology, vascular stiffness, cardiac biomarkers, body composition, bone mineral density, muscle strength, physical function, habitual physical activity, cognitive function, and multidimensional quality of life.MethodsOne hundred women with early-stage BCa (40–75 years) scheduled for AC will be randomized to 12-months of structured exercise training (n = 50) or a usual care control group (n = 50). Participants will be assessed at baseline, 4-weeks following completion of AC (4-months) and at 12-months for all measures.DiscussionWomen diagnosed with early-stage BCa have increased cardiac mortality. More sensitive strategies for diagnosing and preventing AC-induced cardiovascular impairment are critical for reducing cardiovascular morbidity and improving long-term health outcomes in BCa survivors.Trial registrationAustralia & New Zealand Clinical Trials Registry (ANZCTR), ID: 12617001408370. Registered on 5th of October 2017.

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