Abstract PS9-36: Exercise therapy to reduce breast cancer fatigue: Results from the EXPECT study
Authors: Invernizzi Marco , de Sire Alessandro , Sajjadi Elham , Venetis Konstantinos , Gennari Alessandra , Fusco Nicola 
Published: February 2021

Abstract
Background. Breast cancer fatigue (BCF) is a complex and multidimensional condition characterized by a persistent sense of physical and/or mental stiffness, resulting in a substantial impairment of health-related quality of life in breast cancer patients and survivors. Several therapeutic approaches have been proposed for BCF. Among them, supervised exercise therapy is a valuable non-pharmacologic option. However, the optimal exercise scheme (i.e. type, combination, frequency, intensity, and duration) remains controversial. Here, we sought to evaluate the effects of a specific therapeutic exercise protocol on BCF and muscle performance. Methods. This is a still-recruiting pilot prospective cohort study including women with a diagnosis of BCF up to two months after breast surgery. Exclusion criteria: Hb &lt;9 g/dl, platelets &lt;150,000/mm3, and brain and/or bone metastases. Intervention: all participants were subjected to a physical exercise rehabilitative protocol consisting of 10 minutes of warm-up, 40 minutes of aerobic exercise (e.g. walking, cycling, rowing) and strength training (e.g. light weightlifting), and 10 minutes of cool-down. Each session was repeated 2 times/week with &gt;2 days of rest for 4 weeks, under the supervision of an experienced physical therapist. Primary outcome evaluation: brief fatigue inventory (BFI). Secondary outcomes: the European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30); hand grip strength test (HGS); short physical performance battery (SPPB); 10 meter walking test (10MWT); 6 minute walking test (6MWT). All outcomes were assessed at baseline (T0), after 1 month (T1), and after 3 months (T2). Results. Of the 102 patients assessed, 48 did not meet the inclusion and exclusion criteria and 18 refused to sign the informed consent. Finally, 36 BC women (mean age: 55.17 ±7.76 years; body mass index: 25.15 ±5.52 kg/m2) were enrolled. BFI showed a statistically significant reduction both at T1 (5.4 ±1.6 vs 4.2 ±1.7; p=0.004) and T2 (5.4 ±1.6 vs 4.4 ±1.6; p=0.004). Furthermore, we found significant differences at T1 in terms of HGS (20.1 ± 5.8 vs 22.5 ± 5.2: p&lt;0.001), SPPB (9.3 ± 2.0 vs 11.3 ± 1.2; p&lt;0.001), 10MWT (1.5 ± 0.3 vs 1.8 ± 0.3; p&lt;0.001), 6MWT (464.5 ± 62.9 vs 554.1 ± 71.6; p&lt;0.001), EORTC QLQ-C30 Functional score (69.2 ± 14.9 vs 76.9 ± 15.7; p&lt;0.001), EORTC QLQ-C30 Symptoms score (29.2 ± 14.9 vs 21.2 ± 16.0: p&lt;0.001), and EORTC QLQ-C30 Global Health score (40.7 ± 12.5 vs 67.6 ± 14.8; p&lt;0.001). At 2 months (T2), all the outcome measures significantly differ from the baseline (p&lt;0.05), including FFM (43.2±6.4 vs 45.5±6.6; p&lt;0.001) and FM (24.0±10.6 vs 21.7±10.0; p&lt;0.001), as showed by Table 3. Moreover, the GPE score measured at T1 was 2.20 considering patients’ perspective and 2.40 considering physical therapists’ perspective.Conclusions. The physical exercise rehabilitation protocol proposed herein might be a feasible, safe, reliable and effective intervention in reducing BCF and improving muscle mass, function, and health-related quality of life in breast cancer survivors. Further studies are needed to define the role of physical rehabilitation in the multidisciplinary management of BCF.
Citation Format: Marco Invernizzi, Alessandro de Sire, Elham Sajjadi, Konstantinos Venetis, Alessandra Gennari, Nicola Fusco. Exercise therapy to reduce breast cancer fatigue: Results from the EXPECT study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-36.