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Exercise as a diagnostic and therapeutic tool to prevent cardiovascular morbidity in breast cancer survivors: a randomised trial

The chemotherapy medications used for breast cancer treatment are important for achieving a cure but a potential side effect is that they can negatively affect heart function. Current tools used to assess heart function during and following breast cancer treatment have limitations in their ability to accurately predict those who will go on to develop heart problems. Aerobic fitness is an important predictor of health outcomes in people with certain forms of heart disease, and having a particularly low level of aerobic fitness (termed functional disability) appears very closely linked with the risk of developing heart failure. Importantly, functional disability also reflects an exercise capacity that would limit one’s ability to perform basic activities of daily living such as walking briskly, climbing stairs or gardening.

We are conducting a randomised trial which aims to identify how anthracycline chemotherapy for breast cancer affects exercise capacity and risk of functional disability, and whether a 12-month exercise training program conducted during and following chemotherapy can reduce the risk of developing functional disability. We would also like to assess how the standard test used to measure heart function at rest (left ventricular ejection fraction) compares to state of the art MRI imaging of the heart in being able to predict the risk of becoming functionally disabled following anthracycline chemotherapy. It is hoped that the information from this study will be used to develop guidelines for identifying women at risk of developing heart failure as a result of their breast cancer treatments. Our results will also help to inform exercise recommendations for women undergoing breast cancer treatment with the aim of maintaining cardiovascular health and function.

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