Changes In Health-related Fitness After Breast Cancer Treatment In The AMBER Cohort Study
Bibliographic record
Abstract
Early-stage breast cancer patients often receive multimodal cancer treatments consisting of various combinations of surgery, chemotherapy, radiotherapy, targeted therapy, and hormone therapy. Limited data are available on how these treatment modalities affect different domains of health-related fitness (HRF). PURPOSE: The present study reports the associations between different breast cancer treatment modalities and 1-year changes in HRF. METHODS: Newly diagnosed early-stage breast cancer patients were recruited between 2012-2019 in Edmonton and Calgary, Canada for the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. Participants completed HRF assessments within 90 days of diagnosis and one year after diagnosis including cardiorespiratory fitness (VO2peak treadmill test), muscular fitness (upper and lower body muscular strength and endurance), and body composition (DXA scan). Treatment data were abstracted from electronic medical records. Analysis of covariance examined changes in HRF by different treatment modalities and combinations. RESULTS: AMBER included 1,528 participants of which 41.4% had a mastectomy, 58.2% chemotherapy, 74.3% radiotherapy, 81.6% hormone therapy, and 16% targeted therapy. Receiving chemotherapy was associated with a decrease in upper body strength (p = 0.048), fat-free mass (p = 0.049), and bone mineral density (p < 0.001). Receiving radiotherapy was associated with a decrease in relative VO2peak (p = 0.025) and bone mineral density (p < 0.001). Having a mastectomy was linked to a reduction in upper body endurance (p = 0.037). Receiving hormone therapy was associated with reductions in lower body strength (p = 0.033), lean mass (p = 0.001), and fat-free mass (p = 0.002). Receiving targeted therapy was associated with a decline in relative VO2peak (p = 0.017). The combination of receiving all 5 treatment modalities (n = 55) was associated with increased body weight (p = 0.043) and decreased bone mineral density (p = 0.023). CONCLUSIONS: Different cancer treatments uniquely impact different HRF domains in early-stage breast cancer. Understanding the changes in HRF based on individual and combinations of treatment modalities will inform tailored exercise interventions during and after breast cancer treatments. Team Grant (#107534), Project Grant (#155952), and Foundation Grant (#159927) from the Canadian Institutes of Health Research, Canada Research Chairs Program, Alberta Innovates Health Senior Scholar Award, Alberta Cancer Foundation Weekend to End Women's Cancers Breast Cancer Chair
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".