Please select the eligibility criteria that correspond to the clinical trial below.
Title: Group Phone-Based Weight Control for Rural Breast Cancer Survivors
Brief Summary: Women who are obese at breast cancer diagnosis have a 1.5 to 2.5 increased risk of recurrence and death compared to their normal weight counterparts. Moreover, weight gain and decreased physical activity are common after diagnosis and also increase the likelihood of breast cancer recurrence and death. Rural women suffer from health disparities in breast cancer diagnosis and treatment. Women of the most rural counties also have the highest prevalence of obesity compared to urban women. To address these disparities, the overarching objective of this proposal is to develop a clinically effective and cost efficient strategy for delivering a weight control intervention to rural breast cancer survivors. Group phone-based treatment via conference call is a novel treatment delivery approach that the investigators have shown to be effective for initial weight loss among rural breast cancer survivors and more effective than the standard individual phone-based approach among rural women. This innovative method of providing group treatment addresses access barriers in rural areas and may be especially ideal for rural breast cancer survivors because it provides social support in conjunction with a level of anonymity. However, the impact of group phone counseling during extended care for weight loss maintenance beyond 6 months remains unknown. Weight loss maintenance is the more challenging phase of treatment when weight regain is common, and this regain presents a potential risk for breast cancer recurrence. This randomized controlled trial will evaluate the effects of group phone-based treatment for weight loss maintenance among rural breast cancer survivors, compared to an established mail-based education comparison condition, subsequent to a 6 month group phone-based weight loss phase for both conditions. In addition to the intervention impact on weight loss maintenance, the study will provide estimates of incremental cost-effectiveness per kg loss between the two conditions and the impact on secondary outcomes including quality of life, breast cancer risk biomarkers, dietary intake, and physical activity.


Options:
A: Inclusion Criteria:

* Participants will be screened for the following inclusion criteria:
* Age \>18 years
* History of stage 0, I, II, or IIIa breast cancer and no evidence of recurrent disease
* Within 6 weeks of completion of breast cancer therapy (Surgery, Radiation or Chemotherapy)
* Caucasian and/or Hispanic (English or Spanish-speaking)
* Willing to undergo a 1 hr cancer survivorship evaluation

Exclusion Criteria:

* Patients with the following active conditions or behaviors will be excluded from participation:
* Evidence of recurrent or metastatic breast cancer
* Patients who have received surgery only with no adjuvant therapy
* Uncontrolled or significant psychiatric illness/social situations that would preclude completion of questionnaire or follow-up evaluation.
B: Inclusion Criteria:

* histologically confirmed breast cancer.
* mentally competent.
* physician approval to participate in the study.
* free from chronic medical and orthopaedic conditions.
* no current or planned pregnancy.
* ability to read and understand English.
* must be in the post treatment phase of their cancer trajectory.
* willing to accept random assignment.
* not currently participating in another QoL intervention.
* no known or active metastatic disease.
C: Inclusion Criteria:

* Breast cancer patients with a BMI 27-45 kg/m2
* Diagnosis of Stage 0-IIIc disease within the past 10 years (except Stage 0, treated with mastectomy only)
* Have completed all local and systemic therapy at least 3 months prior to entry
* Have clearance from their oncologist or current medical provider to participate in a weight control study
* Must be ≤ 75 years old
* Post-menopausal
* Participants must live in a rural area
* Have access to a phone
* Able to participate in the physical activity component of the intervention, i.e., be able to walk briskly unassisted and without serious medical risk
* Weight stable within ten pounds three months prior to entry

Exclusion Criteria:

* Women with insulin-dependent diabetes
* Ongoing participation in a formal weight loss program
* Ongoing use of pharmacotherapy for weight loss
* Ongoing use of medications that seriously affect weight and metabolism (e.g., steroids, phentermine)
* Positive screen for current substance abuse, major depression, or binge eating disorder
* Any cardiac or pulmonary disease preventing participation
* Treatment for any other cancers within the past year
* Previous bariatric surgery
D: Inclusion Criteria:

* Female 18 y and over,
* Diagnosed with invasive breast cancer (Stage I-III) within two years of enrolment and no evidence, or clinical suspicion, of metastatic disease,
* Post-surgery and had no surgery planned for the next six months at least,
* Had fully completed adjuvant therapy (radiotherapy and/or chemotherapy) not including hormonal therapy,
* No previous malignancy except in the case of ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), basal cell carcinoma or cervical carcinoma in situ, or where the patient has been disease-free for 10 years,
* No concomitant medical or psychiatric problems that might prevent completion of treatment or follow-up,
* Willing to be randomised, and willing to maintain contact with the investigators over the six months

Exclusion Criteria:

* No evidence of invasive breast cancer (i.e. only pre-invasive disease identified),
* Previous invasive breast cancer (surgically treated DCIS or LCIS is allowed),
* Inability to participate in PA because of severe disability (e.g. severe arthritic conditions), psychiatric illness and vulnerable subjects, such as pregnant women.
* Any other patient where PA was not approved by their oncologist due to the presence of one or more contraindications to exercise in cancer patients.

Answer: C