Cardiometabolic Profile, Physical Activity, and Quality of Life in Breast Cancer Survivors after Different Physical Exercise Protocols: A 34-Month Follow-Up Study

Abstract

Background: Breast cancer (BC) and cardiovascular (CV) disease share many risk factors associated with worse outcomes, in terms of cancer relapse, CV events, and quality of life (QoL), that could be counteracted by physical exercise (PE). We aimed to assess the impact of a 12-week differential PE protocol on cardiometabolic profile, QoL, CV- and BC-related long-term outcomes, and physical activity (PA) in a cohort of BC survivors (BCS) not treated with chemotherapy.

Methods: 57 BCS participated in a 12-week PE protocol [aerobic exercise training (AET) or resistance exercise training (RET)]. Anthropometric and CV evaluation, health-related (HR)-QoL, daily PA, cortisol, and dehydroepiandrosterone sulfate (DHEA-S) levels were assessed before (T0) and after (T1) PE. We assessed BC and CV outcomes, HR-QoL, CV-QoL, and PA at the follow-up.

Results: RET improved waist circumference, DHEA-S, cortisol/DHEA-S, systolic and mean blood pressure, and ventricular/arterial coupling; AET ameliorated sagittal abdomen diameter and pulse wave velocity. Regarding HR-QoL, physical function improved only in AET group. At a mean 34 ± 3.6-month follow-up, we documented no significant differences in CV-QoL, HR-QoL, and PA or CV and BC outcomes.

Conclusions: AET and RET determine specific, positive adaptations on many parameters strongly related to CV risk, CV and BC outcomes, and QoL, and should be included in any cardio-oncology rehabilitation program.

Keywords: aerobic exercise training; breast cancer; breast cancer survivors; cancer therapy-related cardiovascular toxicity; cardiometabolic profile; cardiovascular-related quality of life; health-related quality of life; hormone therapy; physical activity; physical exercise; resistance exercise training.

Figure 1

Flowchart of the study protocol. Abbreviations: CV, cardiovascular; WC, waist circumference; HC, hip circumference; SAD, sagittal abdomen diameter; ECG, electrocardiogram; TTE, transthoracic echocardiogram; IMT, intima-media thickness; BP, blood pressure; PWV, pulse wave velocity; AET, aerobic exercise training; W, walking; NW, Nordic walking; RET, resistance exercise training; QoL, quality of life; PE, physical exercise; PA, physical activity; IPAQ, International Physical Activity Questionnaire; SAQ-7, Seattle Angina Questionnaire-7; SF-36, Short Form Health Survey-36.