scholarly journals Congruence and trajectories of device-measured and self-reported physical activity during therapy for early breast cancer

2021 ◽  
Author(s):  
H. Helbrich ◽  
M. Braun ◽  
C. Hanusch ◽  
G. Mueller ◽  
H. Falk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Early Breast Cancer ◽  
Metastatic Breast ◽  
Weighted Kappa ◽  
Self Report ◽  
Activity Levels ◽  
Primary Therapy ◽  
Breast Cancer Patients ◽  
Activity Data

Abstract Purpose This study examines congruence between self-reported and device-measured physical activity data in women with early breast cancer and compares trajectories under different treatments. Methods Women with non-metastatic breast cancer were recruited before primary therapy. In four weeks distributed over six months after treatment start, patients reported time spent on work, transport, chores and sports via diary and wore Garmin® vivofit 3 accelerometers to assess steps taken. Associations between these measures and agreement regarding guideline adherence were tested with Spearman’s Correlation Coefficient and Weighted Kappa statistic. Effects of time and treatment were evaluated using mixed analyses of variance. Results Ninety-nine participants (median age = 50) were treated with adjuvant (N= 23), neoadjuvant (N= 21) or without chemotherapy (N= 55). Coherence between self-report and device data was strong (r = 0.566). Agreement about reaching recommendations was only “fair” (kappa coefficient = 0.321 and 0.249, resp.). Neither treatment or week nor their interaction had effects on step counts (all p > 0.05). Self-reported activity time was lower for patients with chemotherapy than for those without (adjuvant: ∆ = 69min, p= 0.006, neoadjuvant: ∆ = 45min, p= 0.038) and lower in week 18 than in week 3 (∆ = 43min, p= 0.010). Conclusion Results show that consumer-grade activity monitors and self-reports correlate but show different perspectives on physical activity in breast cancer patients. In general, patients perceive some decline regardless of primary treatment regimen. Those affected should be offered assistance to gain the benefits of activity. Accelerometers may help professionals to identify these individuals and patients to verify appraisal of their activity levels.

Objective assessment of physical activity during chemotherapy for breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS6626-TPS6626 ◽  
Author(s):  
Michelle E. Melisko ◽  
Edward Kenji Hadeler ◽  
Sandahl H Nelson ◽  
Audrey Lunde ◽  
Irene Acerbi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Objective Assessment ◽  
Smart Phone ◽  
Metastatic Breast ◽  
Activity Levels ◽  
Breast Cancer Patients ◽  
Eligibility Criteria ◽  
Anxiety Depression

TPS6626 Background: Exercise can alleviate side effects of chemotherapy, improve quality of life (QOL), and positively impact disease specific and overall survival. Despite the benefits of physical activity (PA), many patients’ activity levels decrease during chemotherapy. Wearable devices, such as the Fitbit, can provide insight into patterns of activity, and help encourage behavior change. The aims of this study are: 1) determine the feasibility/acceptability of using a Fitbit to measure PA and sleep throughout chemotherapy for breast cancer; 2) describe patterns of PA, sedentary time, and sleep during chemotherapy; 3) explore associations of activity and sleep with QOL. Methods: Non-metastatic breast cancer patients from UCSF and UCSD will be enrolled prior to starting chemotherapy. Eligibility criteria include ability to speak/read English, walk unassisted, and access to internet or Fitbit compatible smart phone. Patients sign informed consent, receive a Fitbit Charge HR and guidance on how to use the device. Patients are instructed to wear the Fitbit throughout their adjuvant or neoadjuvant chemotherapy and 6 months post therapy and to sync the Fitbit at least weekly. Patients complete surveys at start, midpoint, end, and 6 months post chemotherapy. Questionnaires include PROMIS anxiety, depression, physical function, fatigue, cognitive function, social roles, comfort with technology and usefulness of the Fitbit. Fitabase database collects minute level activity, sleep, and heart rate. To assess feasibility, we will evaluate if a participant wears FitBit for at least 10 hour per day for ≥ 80% of the days during chemotherapy. We will use mixed effects regression models to assess patterns of PA and associations between activity and QOL. All models will include activity time and Fitbit wear time and will control for the potential confounding effects of age and other demographic or clinical variables. As of February 6 2017, 48 out of a planned 80 patients are enrolled. Acknowledgment: Athena Breast Health Network investigators and patients; support at UCSD by NCI (U54 CA155435-01) and by gift from Carol Vassiliadis and family; NCI grant K07CA181323 to SH; UCSF M Zion Health Fund Award, GBCTB unrestricted funding and TriValley SOCKS to MM. Clinical trial information: NCT03041545.

scholarly journals Physical activity and fitness in women with metastatic breast cancer.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 136-136
Author(s):  
Jasmine Yee ◽  
Glen M Davis ◽  
Jane McNeil Beith ◽  
Nicholas Wilcken ◽  
Rina Hui ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Metastatic Breast Cancer ◽  
Aerobic Fitness ◽  
Lower Limb ◽  
Handgrip Strength ◽  
Disease Onset ◽  
Metastatic Breast ◽  
Activity Levels ◽  
Lower Limb Strength

136 Background: Women with metastatic breast cancer may survive for many years after disease onset, and there is little published evidence on their habitual levels of physical activity. The aim of this study was to investigate differences in physical activity levels and physical fitness between women with and without metastatic breast cancer. Methods: Seventy-one women with metastatic breast cancer (METS) aged 57.7 ± 9.5 y and 2.9 ± 3.1 y after disease onset, and 71 healthy controls (CONTROLS) aged 55.0 ± 9.4 y participated. Of those with metastatic disease, 27% had metastases in bone only, 35% in viscera only and 38% in both bone and viscera. Strength was measured using hand and leg dynamometry, aerobic fitness using the Modified Canadian Aerobic Fitness Test, and fatigue with the FACT-Fatigue questionnaire. Participants wore a SenseWear physical activity armband over 6 days, and the average steps taken per day over 5 of these days, where there was a minimum wear time of 8 hours per day, was derived. Results: METS possessed lower aerobic fitness than CONTROLS (25.3 ± 5.4 versus 31.9 ± 6.1 ml·kg·min-1 respectively; p<0.01). METS were significantly weaker than CONTROLS. Lower limb strength for the METS and CONTROLS was 53.8 ± 23.7 versus 76.0 ± 27.4 kg and handgrip strength was 26.6 ± 6.0 versus 30.2 ± 6.4 kg. METS were also significantly less active, attaining only 57% of the daily step counts of CONTROLS. Fatigue was significantly higher in women with metastatic cancer compared to their healthy counterparts (38.0 ± 9.8 versus 46.3 ± 4.6; p<0.01). Correlation between fatigue with average steps per day (r=0.46), handgrip strength (r=0.29) and leg strength (r=0.26) was low in the METS group. Conclusions: Women living in the community with metastatic breast cancer are weaker, have lower aerobic fitness, and are relatively inactive compared to their healthy counterparts. Increased fatigue in these women is poorly associated with their decreased physical activity levels, hand and lower limb strength. Women with metastatic breast cancer may benefit from a program directed at improving their strength and fitness. Acknowledgements: Funded by National Breast Cancer Foundation, Australia.

scholarly journals Gemcitabine as adjuvant chemotherapy in patients with high-risk early breast cancer—results from the randomized phase III SUCCESS-A trial

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Amelie de Gregorio ◽  
Lothar Häberle ◽  
Peter A. Fasching ◽  
Volkmar Müller ◽  
Iris Schrader ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Early Breast Cancer ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Tumor Grade ◽  
Phase Iii ◽  
Primary Study ◽  
Breast Cancer Patients ◽  
Standard Chemotherapy

Abstract Background When chemotherapy is indicated in patients with early breast cancer, regimens that contain anthracyclines and taxanes are established standard treatments. Gemcitabine has shown promising effects on the response and prognosis in patients with metastatic breast cancer. The SUCCESS-A trial (NCT02181101) examined the addition of gemcitabine to a standard chemotherapy regimen in high-risk early breast cancer patients. Methods A total of 3754 patients with at least one of the following characteristics were randomly assigned to one of the two treatment arms: nodal positivity, tumor grade 3, age ≤ 35 years, tumor larger than 2 cm, or negative hormone receptor status. The treatment arms received either three cycles of 5-fluorouracil, epirubicin, and cyclophosphamide, followed by three cycles of docetaxel (FEC → Doc); or three cycles of FEC followed by three cycles of docetaxel and gemcitabine (FEC → Doc/Gem). The primary study aim was disease-free survival (DFS), and the main secondary objectives were overall survival (OS) and safety. Results No differences were observed in the 5-year DFS or OS between FEC → Doc and FEC → Doc/Gem. The hazard ratio was 0.93 (95% CI, 0.78 to 1.12; P = 0.47) for DFS and 0.94 (95% CI, 0.74 to 1.19; P = 0.60) for OS. For patients treated with FEC → Doc and FEC → Doc/Gem, the 5-year probabilities of DFS were 86.6% and 87.2%, and the 5-year probabilities of OS were 92.8% and 92.5%, respectively. Conclusion Adding gemcitabine to a standard chemotherapy does not improve the outcomes in patients with high-risk early breast cancer and should therefore not be included in the adjuvant treatment setting. Trial registration Clinicaltrials.gov NCT02181101 and EU Clinical Trials Register EudraCT 2005-000490-21. Registered September 2005.

scholarly journals Circulating Tumor Cells in Early Breast Cancer

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Laura Thery ◽  
Alessandra Meddis ◽  
Luc Cabel ◽  
Charlotte Proudhon ◽  
Aurelien Latouche ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Early Breast Cancer ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Level Of Evidence ◽  
Free Survival ◽  
Meta Analyses

AbstractCirculating tumor cells (CTCs) are particularly rare in non-metastatic breast cancer, and the clinical validity of CTC detection in that clinical setting was initially not well recognized. A cytological CTC detection device (CellSearch) fulfilling the CLIA requirements for analytical validity was subsequently developed and, in 2008, we reported the first study (REMAGUS02) showing that distant metastasis-free survival was shorter in early breast cancer patients with one or more CTCs. In the past 10 years, other clinical studies and meta-analyses have established CTC detection as a level-of-evidence 1 prognostic biomarker for local relapses, distant relapses, and overall survival. This review summarizes available data on CTC detection and the promises of this proliferation- and subtype-independent metastasis-associated biomarker in early breast cancer patients.

scholarly journals Circulating Tumor Cells in Breast Cancer Patients: An Evolving Role in Patient Prognosis and Disease Progression

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Holly Graves ◽  
Brian J. Czerniecki
Keyword(s):  
Breast Cancer ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Early Breast Cancer ◽  
Primary Tumor ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Neoplastic Process

In this paper, we examine the role of circulating tumor cells (CTCs) in breast cancer. CTCs are tumor cells present in the peripheral blood. They are found in many different carcinomas but are not present in patients with benign disease. Recent advances in theories regarding metastasis support the role of early release of tumor cells in the neoplastic process. Furthermore, it has been found that phenotypic variation exists between the primary tumor and CTCs. Of particular interest is the incongruency found between primary tumor and CTC HER2 status in both metastatic and early breast cancer. Overall, CTCs have been shown to be a poor prognostic marker in metastatic breast cancer. CTCs in early breast cancer are not as well studied, however, several studies suggest that the presence of CTCs in early breast cancer may also suggest a poorer prognosis. Studies are currently underway looking at the use of CTC level monitoring in order to guide changes in therapy.

scholarly journals Management of Early Breast Cancer at an Australian Cancer Centre During the Early Phase of COVID-19 Pandemic

2021 ◽  
pp. 318-328
Author(s):  
Elissa J Zhang ◽  
Kirsty Stuart ◽  
Rina Hui ◽  
Rhiannon Mellor ◽  
Wei Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Standard Treatment ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Tertiary Referral Hospital ◽  
Reconstructive Procedures ◽  
Team Meetings ◽  
The Impact

Background: This study aimed to prospectively record changes to treatment for early breast cancer patients during the first wave of the COVID-19 pandemic in Australia.  The purpose was to assess the impact on breast cancer outcomes and to determine the need for any mitigative actions.  Methods: The study was conducted in the breast cancer unit of a tertiary referral hospital. Patients with early (non-metastatic) breast malignancy discussed in multidisciplinary team meetings between March and June 2020 were included. Patients were newly diagnosed, post-operative or post-neoadjuvant chemotherapy. Standard treatment was defined by Westmead Breast Cancer Institute protocols and any variations related to the pandemic were recorded. Results: In the study, 145 patients were included (median age 59 years). Pandemic-related changes to management were noted in 13 of 145 (9.0%) patients. Four patients experienced a delay to cancer treatments, four were not offered reconstructive/ symmetrisation surgical procedures, three had altered radiotherapy protocols and two patients were not offered enrolment to a clinical trial. These impacts affected the groups presenting with new cancers (n=7/86, 8.1%), post-operative cases (n=4/25, 16.0%) and post-neoadjuvant chemotherapy cases presenting for surgical planning (n=2/34, 5.9%).  Conclusion: Most patients (91.0%) received standard treatment during the first wave of the pandemic. The minor variations from institutional protocols observed in this study are unlikely to affect local control or survival in this patient cohort, but close follow-up is required. Quality of life may have been affected for four patients who had downgraded or delayed reconstructive procedures.

scholarly journals Study protocol for a nationwide questionnaire survey of physical activity among breast cancer survivors in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032871
Author(s):  
Yoichi Shimizu ◽  
Katsunori Tsuji ◽  
Eisuke Ochi ◽  
Hirokazu Arai ◽  
Ryo Okubo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Population Distribution ◽  
Self Report ◽  
Cancer Center ◽  
Activity Levels ◽  
Cross Sectional Survey ◽  
Cross Sectional

IntroductionA major concern is that few cancer survivors meet the guidelines for recommended levels of physical activity. No studies have investigated physical activity among breast cancer survivors nationwide in Japan. Therefore, the aims of this study are to identify the levels of physical activity among breast cancer survivors, to examine factors-related physical activity among breast cancer survivors and to identify breast cancer survivors’ preferences for and interest in exercise programmes in order to inform the future programme development.Methods and analysisWe will administer a cross-sectional survey using a self-report questionnaire to breast cancer survivors. At each of 50 facilities selected to include a variety of institutional backgrounds according to the population distribution of different regions throughout Japan, we will consecutively distribute the questionnaire to 30 outpatients who have completed initial treatments, except for hormone therapy. The target sample size is 1500 survivors. We will calculate descriptive statistics for each measurement item and perform univariate and multivariate analyses using outcome measures (eg, physical activity and quality of life) related to physical, psychological, social and environmental factors.DiscussionThis is the first nationwide survey of physical activity levels among breast cancer survivors in Japan. Identifying the factors associated with physical activity will help us to develop, disseminate and implement programmes that encourage more survivors to adhere to physical activity guidelines.Ethics and disseminationThe protocol was approved by the Institutional Review Board (IRB) of the National Cancer Center on 11 January 2019 (ID: 2018–295). In addition, many of the participating facilities required ethical approval from their local IRBs, while others did not. Accordingly, approval from the local IRBs of individual facilities was obtained when required. The findings will be disseminated through peer-reviewed publications and conference presentations.

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