Predicting Effective Adaptation to Breast Cancer to Help Women BOUNCE Back: Protocol for a Multicenter Clinical Pilot Study
Authors: Pettini Greta , Sanchini Virginia , Pat-Horenczyk Ruth , Sousa Berta , Masiero Marianna , Marzorati Chiara , Galimberti Viviana Enrica , Munzone Elisabetta , Mattson Johanna , Vehmanen Leena , Utriainen Meri , Roziner Ilan , Lemos Raquel , Frasquilho Diana , Cardoso Fatima , Oliveira-Maia Albino J , Kolokotroni Eleni , Stamatakos Georgios , Leskelä Riikka-Leena , Haavisto Ira , Salonen Juha , Richter Robert , Karademas Evangelos , Poikonen-Saksela Paula , Mazzocco Ketti 
Published: April 2022

Background
Despite the continued progress of medicine, dealing with breast cancer is becoming a major socioeconomic challenge, particularly due to its increasing incidence. The ability to better manage and adapt to the entire care process depends not only on the type of cancer but also on the patient’s sociodemographic and psychological characteristics as well as on the social environment in which a person lives and interacts. Therefore, it is important to understand which factors may contribute to successful adaptation to breast cancer. To our knowledge, no studies have been performed on the combination effect of multiple psychological, biological, and functional variables in predicting the patient’s ability to bounce back from a stressful life event, such as a breast cancer diagnosis. Here we describe the study protocol of a multicenter clinical study entitled “Predicting Effective Adaptation to Breast Cancer to Help Women to BOUNCE Back” or, in short, BOUNCE.

Objective
The aim of the study is to build a quantitative mathematical model of factors associated with the capacity for optimal adjustment to cancer and to study resilience through the cancer continuum in a population of patients with breast cancer.

Methods
A total of 660 women with breast cancer will be recruited from five European cancer centers in Italy, Finland, Israel, and Portugal. Biomedical and psychosocial variables will be collected using the Noona Healthcare platform. Psychosocial, sociodemographic, lifestyle, and clinical variables will be measured every 3 months, starting from presurgery assessment (ie, baseline) to 18 months after surgery. Temporal data mining, time-series prediction, sequence classification methods, clustering time-series data, and temporal association rules will be used to develop the predictive model.

Results
The recruitment process stared in January 2019 and ended in November 2021. Preliminary results have been published in a scientific journal and are available for consultation on the BOUNCE project website. Data analysis and dissemination of the study results will be performed in 2022.

Conclusions
This study will develop a predictive model that is able to describe individual resilience and identify different resilience trajectories along the care process. The results will allow the implementation of tailored interventions according to patients’ needs, supported by eHealth technologies.

Trial Registration
ClinicalTrials.gov NCT05095675; https://clinicaltrials.gov/ct2/show/NCT05095675

International Registered Report Identifier (IRRID)
DERR1-10.2196/34564