Feasibility of a 6-Month Diet, Exercise, and Behavior Modification Intervention for Post-Menopausal Breast Cancer Survivors.

Background: Obesity is prevalent in general population and among breast cancer (BrCa) survivors. Weight at diagnosis and weight gain after diagnosis are associated with increased risk of breast cancer recurrence and mortality. Regular exercise similarly reduces the risk of dying from breast cancer. This study was conducted to determine the feasibility of a structured diet/exercise/behavioral intervention program with a goal to achieve a weight loss of 5% or more, and to study the effect of participation in the program on serum biomarkers of breast cancer risk, measures of overall health, strength, and fitness level..Methods: Subjects in this prospective pilot study are female, overweight BrCa survivors with a BMI >25, and who were at least 3 months out of adjuvant chemotherapy. The 6-month combined modality diet/exercise/behavior modification intervention included: 225 minutes per week of cardiovascular exercise in addition to resistance training, a 1200-1500 calorie/day diet including participant purchased pre-packaged meals and low calorie shakes, and a weekly in-person group behavioral meeting. Women were recruited into groups of 10 to15 participants (total n=50), with a planned goal of 4 cohorts, and anticipated complete data collection by December 2009. Participants underwent pre and post intervention assessments including: anthropometric measures, serum biomarkers, fitness test, and questionnaires to assess food frequency, fatigue, and quality of life. Changes over time were assessed using Wilcoxon signed rank test. We present here the data on first 12 women who have completed the 6 month intervention, out of a planned accrual of 50.Results: Since November 2008, 55 women were screened and 38 women agreed to participate in the 6-month intervention (13 in cohort 1; 10 in cohort 2; 15 in cohort 3). Only 1 participant dropped out of cohort 1 due to a non-study related injury. Major reasons for not participating included: already started another weight loss program, timing, and lack of availability for the evening meeting. Mean age of the participants was 50.7 (range 40-57) and mean time from diagnosis to the time of enrollment was 45 months (range 20-132). Eight five percent of the participants received adjuvant or neo-adjuvant chemotherapy and 77% were either currently or had previously taken anti-hormonal therapy.Median weight was 230 lbs (range 165-268) at baseline .and 198 lbs (range 139.6-243.8) at 6 month (median weight loss: 32 lbs or 14%; p=0.00); median BMI was 36.4kg/m2 (range 30.3-45.4) at baseline and 31.54kg/m2 (range 26.4-40.7) at 6-months (p=0.00), median percent body fat by DEXA scan was 50.9 (range 45-58.4) at baseline and 46.3 (range 35.6-55.4) at 6-months (p=0.00). Participants increased their metabolic equivalent task hours per week (MET/HRS) of exercise from 6.6 (range 0-25) at baseline to 20.4 (range11.8-40.5) at 6-months (p=0.01).Conclusion: A 6-month diet/exercise/behavior modification intervention program is feasible and results in a significant decrease in overall weight and percent body fat among overweight breast cancer survivors. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1058.