Exercise During Breast Cancer Treatment: Results Of The NEXT-BRCA Randomized Controlled Trial

PURPOSE: To determine the feasibility and effectiveness of institution-based exercise and self-management education on improving outcomes for individuals receiving treatment for breast cancer (BC). METHODS: A hybrid implementation-effectiveness study was conducted at a single site in Canada. Eligible participants included adult females with a current diagnosis of stage 1-3 BC undergoing treatment. Participants were randomized to one of three groups: 1) Exercise and self-management (EXSM; 8 in person sessions of moderate intensity aerobic exercise, self-management education, 4 booster sessions), 2) SM only (8 virtual sessions of self-management education, 4 booster sessions), or 3) usual care (no intervention). Feasibility (recruitment, retention, and adherence rates) and effectiveness (physical activity level (primary), exercise knowledge and behaviour, perception of health status, quality of life, and physical functioning) were assessed pre and post intervention, and at 6- and 12-month follow-up. Descriptive statistics described feasibility outcomes and an ANCOVA was used to assess effectiveness over time. RESULTS: Eighty-five participants enrolled in the study. Most were 40-60 years of age (56%), living with stage 2 BC (46%), and receiving chemotherapy (68%). Feasibility outcomes demonstrated a recruitment rate of 72%, retention rates of 75% (EXSM) and 93% (SM), and adherence rates of 76% (EXSM) and 93% (SM). ANCOVA analysis demonstrated a significant effect of group and timepoint interaction on all outcomes. The EXSM group showed a significant improvement in our primary outcome, physical activity level, compared to UC at the post-intervention (t = 6.00, p < 0.001), 6-month follow-up (t = 9.70, p < 0.001), and 12-month follow-up (t = 7.85, p < 0.001). The SM only group also showed a significant improvement compared to UC at all three timepoints (post-intervention: t = 6.87, p < 0.006; 6-month follow-up: t = 8.67, p < 0.001; 12-month follow up: t = 8.90, p < 0.001). No adverse events occurred during the intervention. CONCLUSION: Institution-based exercise and virtual self-management is feasible for individuals with BC during treatment and is effective in improving outcomes. Future research should consider triaging exercise strategies based on an individual’s cancer and personal characteristics. Supported by: Juravinski Hospital and Cancer Centre Foundation (Grant #T210)