Associations Of Health-related Fitness With Depression, Sleep Quality, And Fatigue In Newly Diagnosed Breast Cancer Patients

PURPOSE: Preventing and managing breast cancer-related symptoms soon after diagnosis is essential as they may undermine quality of life, treatment outcomes, and survival. The purpose of this study was to examine the associations of health-related fitness (HRF) with depression, sleep quality, and fatigue in newly diagnosed breast cancer patients. METHODS: Baseline data collected within 90 days of diagnosis as part of the Alberta Moving Beyond Breast Cancer (AMBER) cohort Study were used in this study. Cardiopulmonary fitness (treadmill VO2peak test), muscular strength and endurance (chest and leg press), flexibility (sit-and-reach test), and body composition (DXA scan) were assessed for HRF; and depression severity, sleep quality, and fatigue were assessed for patient-reported symptoms. Adjusted univariate and multivariable logistic regression were performed to examine the associations between HRFs and symptoms. RESULTS: A total of 1,458 participants were included in the analyses of which 10.4% reported moderate to severe depression, 51.5% reported poor sleep quality, and 26.5% reported significant fatigue. In multivariable-adjusted models, significant associations of lower relative VO2peak were identified with moderate to severe depression (p < 0.001), poor sleep quality (p = 0.009), significant fatigue (p = 0.008), any symptom (p < 0.001), and multiple symptoms (p < 0.001). Participants with lower relative upper body endurance were more likely to have significant fatigue in a dose-response manner (p = 0.001) whereas those with higher body weight (2nd and 3rd quartile groups) were more likely to have poor sleep quality in an inverted-U pattern (p = 0.021). CONCLUSIONS: A significant proportion of newly diagnosed breast cancer patients experience poor sleep quality, significant fatigue, and moderate to severe depression. Moreover, relative VO2peak is a critical parameter associated with those patient-reported symptoms. Additionally, improving absolute cardiopulmonary fitness and maintaining a healthy body weight may be effective strategies to manage all three symptoms, and improving upper body muscular endurance may provide additional benefits for fatigue. Future work may consider examining different exercise interventions to address specific symptom management in this population. a Team Grant (#107534), a Project Grant (#155952), and a Foundation Grant (#159927) from the Canadian Institutes of Health Research, the Canada Research Chairs Program, Alberta Innovates Health Senior Scholar Award, y the Alberta Cancer Foundation Weekend to End Women's Cancers BreastCancer Chair