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Brief Report
March 28, 2019

Effect of Aerobic and Resistance Exercise Intervention on Cardiovascular Disease Risk in Women With Early-Stage Breast Cancer: A Randomized Clinical Trial

Author Affiliations
  • 1Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles
  • 2Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
  • 3Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham
  • 4Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
  • 5Division of Biomarkers of Early Detection and Prevention, Beckman Research Institute, City of Hope National Medical Center, Duarte, California
  • 6Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles
  • 7Division of Endocrinology and Diabetes, Keck School of Medicine, University of Southern California, Los Angeles
  • 8Division of Medical Oncology and Experimental Therapeutics, City of Hope National Medical Center, Duarte, California
JAMA Oncol. 2019;5(5):710-714. doi:10.1001/jamaoncol.2019.0038
Key Points

Question  Does exercise affect the risk of developing cardiovascular diseases in patients with early-stage breast cancer?

Findings  This randomized clinical trial of 100 women with stage I to III breast cancer who were sedentary and with overweight condition or obesity found that the 10-year risk of developing cardiovascular disease, as assessed by the Framingham Risk Score, was significantly lower in patients with early-stage breast cancer who participated in a 16-week exercise intervention.

Meaning  Supervised clinical exercise appeared to be an effective strategy for reducing the 10-year risk of cardiovascular disease in patients with early-stage breast cancer.

Abstract

Importance  The Framingham Risk Score (FRS) is a valid method for predicting the 10-year risk of developing cardiovascular disease. Higher FRS is reported in patients with early-stage breast cancer who are overweight than in healthy, age-matched women, but whether exercise reduces FRS in this patient population is unclear.

Objective  To examine the effects of a 16-week aerobic and resistance exercise intervention on the FRS in women with early-stage breast cancer and with overweight condition or obesity.

Design, Setting, and Participants  This single-center, prospective randomized clinical trial included 100 women with stage I to III breast cancer who were sedentary, with overweight condition or obesity (body mass index of ≥25.0 or body fat of ≥30%), and completed cancer treatment within 6 months prior to enrollment. Participants were randomized to either the usual care or exercise group. Differences in mean changes for outcomes were evaluated using mixed-model repeated-measures analyses. Data were collected from August 1, 2012, through July 1, 2017. Data analysis, which followed the intention-to-treat approach, was performed from May 24 to October 2, 2018.

Interventions  The exercise group underwent supervised aerobic and resistance exercise sessions thrice weekly for 16 weeks.

Main Outcomes and Measures  The FRS was calculated for each participant using preset points for each of the 6 FRS categories: age, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, diabetes presence, and smoking status.

Results  In total, 100 women were randomized to either the exercise group (n = 50) or usual care group (n = 50). Of these women, 55 (55%) were of Hispanic white race/ethnicity and the mean (SD) age was 53.5 (10.4) years. The mean (SD) total FRS scores postintervention were 2.0 (1.5) in the exercise group and 13.0 (3.0) in the usual care group. The postintervention FRS was significantly reduced in the exercise group compared with the usual care group (mean, −9.5; 95% CI, −13.0 to −6.0), which corresponds to an 11% (95% CI, −15.0 to −5.0) decrease on the FRS-predicted 10-year risk of developing cardiovascular disease.

Conclusions and Relevance  A 16-week supervised aerobic and resistance exercise intervention appeared to reduce the FRS-predicted 10-year risk of cardiovascular disease in women with early-stage breast cancer with overweight condition or obesity.

Clinical Trial Registration  ClinicalTrials.gov identifier: NCT01140282

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