Breast cancer treatment-associated cardiovascular toxicity and effects of exercise countermeasures

Abstract

Advances in breast cancer treatment have improved disease-free survival and overall survival in women with early-stage breast cancer. However, these improvements may be attenuated by the adverse cardiovascular effects associated with breast cancer adjuvant therapy. Exercise may be a potential strategy to counteract these toxicities. The purpose of this paper is to provide an overview on the adverse cardiovascular effects of breast cancer therapy as well as the evidence supporting the potential cardioprotective effects of exercise training in breast cancer patients during and after treatment. We will also discuss research gaps and avenues for future research.

Keywords: Breast cancer; Cardiotoxicity; Chemotherapy; Exercise; Physical activity.

Fig. 1

Suggested algorithm for exercise prescriptions in breast cancer patients. A pre-exercise screening assessment should be considered for patients seeking to begin a regular exercise regimen, taking into consideration baseline exercise level, comorbid conditions, and cancer management details. Additional consultation should be considered at the discretion of the treating provider. Patients who do not meet the American College of Sports Medicine (ACSM) guidelines should follow an incremental and step-wise approach to increasing exercise levels. The long-term goal is to perform 20–60 min of moderate to vigorous intensity activity at least 5 days per week. Resistance training can be considered once target exercise levels are achieved. Adapted from references [66, 67], with permission