Effect of Moderate- Intensity Aerobic Exercises on Some Hormonal and Metabolic Factors Associated With Breast Cancer in Overweight Postmenopausal Women

e12532 Background: Early Breast Cancer Trialist Collaborative Group meta-analysis suggested significant reduction in bone metastasis and breast cancer mortality among post-menopausal women diagnosed with early breast cancer when treated with an adjuvant bisphosphonate. Cancer Care Ontario and American Society of Clinical Oncology clinical practice guideline published in 2017, recommends the use of an adjuvant bisphosphonate in postmenopausal women who are candidates for adjuvant systemic therapy. Our goal was to evaluate trends and factors associated with adjuvant bisphosphonate usage since the guideline’s publication. Methods: This study is a retrospective review of postmenopausal women treated for early breast at the London Regional Cancer Program from 2017-2018. Univariate and a multivariable logistic regression models were used to investigate factors potentially associated with adjuvant bisphosphonate use including age, stage, grade, estrogen receptor, progesterone receptor, HER2 receptor status and previous use of adjuvant chemotherapy. The percentage of patients offered, receiving and declining therapy was also recorded and the time interval from surgery to start of bisphosphonate therapy (< 6 months, 6-12 months or >12 months). Results: We identified 286 postmenopausal breast cancer patients, of whom 75 (28%) received adjuvant bisphosphonate therapy. In our multivariable model, cancer stage [odds ratio (OR) stage II vs. I=2.26, 95% confidence interval (CI) 1.08-4.74) and OR Stage III vs. I=4.94, 95% CI 1.84-13.17] and previous use of adjuvant chemotherapy (OR=2.76, 95%CI 1.37-5.55) were significantly associated with adjuvant bisphosphonate use. Among 133 patients who received adjuvant systemic chemotherapy, 51% were offered adjuvant bisphosphonate and of these 81% patients accepted therapy. Among a total of 75 patients receiving adjuvant bisphosphonate therapy 19% initiated therapy within 6 months of surgery, 48% within 6-12 months of surgery, and 33% after 12 months following surgery. Conclusions: Stage and previous use of chemotherapy were significantly associated with adjuvant bisphosphonate therapy. Our study observes the potential underutilization of adjuvant bisphosphonate therapy and possible need to start treatment earlier in some patients. Further education and awareness of the clinical practice guidelines regarding adjuvant bisphosphonate therapy may be warranted and additional population-based study investigating treatment patterns and real-world effectiveness.

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Association between lifestyle factors and completion of neoadjuvant chemotherapy for breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.91 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 91-91

Author(s):

Ilana M Usiskin ◽

Fangyong Li ◽

Melinda L Irwin ◽

Brenda Cartmel ◽

Tara Beth Sanft

Keyword(s):

Breast Cancer ◽

Blood Pressure ◽

Neoadjuvant Chemotherapy ◽

Cancer Diagnosis ◽

Early Stage ◽

Menopausal Status ◽

Lifestyle Factors ◽

Moderate Intensity ◽

Diabetes Medication ◽

Factors Associated

91 Background: Completion of chemotherapy has been associated with improved breast cancer outcomes. We evaluated whether lifestyle factors, such as physical activity and diet, may contribute to neoadjuvant chemotherapy completion in breast cancer. Methods: We conducted a retrospective study of women treated with neoadjuvant chemotherapy for early stage (I-III) breast cancer. A medical record review recorded BMI, blood pressure, diabetes and hypertension medication, and chemotherapy completion. Completers received full doses of all prescribed chemotherapy, with or without cycle delays. We conducted a telephone survey about exercise and fruit/vegetable intake (>5 servings/day) during the year prior to cancer diagnosis. Exercisers completed at least 7.5 MET-hours/week (i.e., 150 minutes of moderate-intensity exercise). Multi-variable adjusted analyses were conducted to identify factors associated with chemotherapy completion. Results: Sixty-seven patients (45%) answered the survey. Chemotherapy completers were on average 11 years younger than non-completers (p<0.001), more likely premenopausal (p=0.02), and less likely on diabetes medication (p=0.05). Exercisers were more likely to complete chemotherapy than non-exercisers (p=0.002). After controlling for age, diastolic blood pressure, menopausal status, and diabetes medication, the adjusted odds ratio for exercise on chemotherapy completion was 4.1 (95% CI 1.1 – 15.3) (p=0.04). Conclusions: Women who reported exercising at recommended levels in the year prior to breast cancer diagnosis were more likely to complete neoadjuvant chemotherapy regimens, suggesting a potentially important role for lifestyle factors in chemotherapy completion. Factors associated with chemotherapy completion [Table: see text]

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Aromatase Inhibitor–Induced Carpal Tunnel Syndrome: Results From the ATAC Trial

Journal of Clinical Oncology ◽

10.1200/jco.2009.22.0236 ◽

2009 ◽

Vol 27 (30) ◽

pp. 4961-4965 ◽

Cited By ~ 52

Author(s):

Ivana Sestak ◽

Francisco Sapunar ◽

Jack Cuzick

Keyword(s):

Breast Cancer ◽

Carpal Tunnel Syndrome ◽

Postmenopausal Women ◽

Early Breast Cancer ◽

Carpal Tunnel ◽

Hormone Replacement ◽

Moderate Intensity ◽

Tunnel Syndrome ◽

Treatment Medication

Purpose Carpal tunnel syndrome (CTS) is a condition in which the median nerve is compressed, leading to pain and muscle weakness in the fingers and hand. Aromatase inhibitors lead to profound estrogen suppression and may be expected to increase the risk of CTS in postmenopausal women receiving adjuvant therapy for early breast cancer. Patients and Methods The current analyses were based on the 100-month median follow-up data in postmenopausal women in the two monotherapy arms (anastrozole, n = 3,092; tamoxifen, n = 3,094). Here, we investigate the natural history of patients who presented with CTS during adjuvant treatment for breast cancer and the relative importance of a range of known risk factors for CTS. Results After 100 months of follow-up, 80 cases (2.6%) of CTS were reported in the anastrozole arm, compared with 23 cases (0.7%) in the tamoxifen arm (P < .0001). The majority of CTS cases were reported as mild to moderate intensity and occurred early. None of the women stopped treatment medication as a result of CTS. CTS was significantly increased for women who used prior hormone replacement therapy (P = .007) or received prior chemotherapy (P = .01). Those who were 60 years of age or older at entry were at lower risk of CTS compared with their counterparts (P = .002). Conclusion Although the use of anastrozole is associated with a greater incidence of CTS, it is rare, and most cases were of mild to moderate intensity and short duration. CTS has little impact on the overall risk-to-benefit ratio for the use of anastrozole in postmenopausal women with early breast cancer.

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