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Updated: Sep 19, 2025
Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
Published on: January 12, 2017
Effects of Aerobic Exercise on Cardiorespiratory Fitness and Cardiovascular Risk Factors in Long-Term Breast Cancer
Sara H Johansen1, Mali Sæter2, Sebastian I Sarvari3
1Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway.
Background:
Cancer treatment may impair physiological adaptations to exercise therapy, yet no study has directly compared exercise effects between cancer survivors and cancer-naive control subjects.
Objectives:
This study sought to examine the effects of aerobic exercise in anthracycline-treated long-term survivors of breast cancer (BCS) and to compare the effects to cancer-naive women.
Methods:
The CAUSE (CArdiovascUlar Survivors Exercise) trial was a 2-arm randomized controlled trial in which long-term BCS were assigned to thrice-weekly nonlinear aerobic exercise for 5 months (BCS exercise) or usual care (BCS usual care). A third group of similarly aged cancer-naive women completed the same exercise intervention. The primary outcome was cardiorespiratory fitness (CRF) (measured as Vo2peak). Secondary outcomes included cardiovascular risk factors (cardiometabolic biomarkers and body composition) and patient-reported outcomes (subjective vitality and life satisfaction).
Results:
Between October 2020 and February 2023, 140 BCS (aged 59.0 ± 6.4 years; 11 ± 1 years after treatment) and 69 cancer-naive women (aged 57.8 ± 4.9 years) were enrolled. From baseline to post-exercise intervention, Vo2peak increased by 1.2 ± 2.6 mL·kg-1·min-1 in the BCS exercise, by 0.01 ± 2.5 mL·kg-1·min-1 in the BCS usual care group (mean difference 1.3; 95% confidence interval [CI]: 0.5-2.1; P = 0.002), and by 2.6 ± 2.5 mL·kg-1·min-1 in non-cancer subjects (BCS exercise vs non-cancer subjects: mean difference -1.4; 95% CI: -2.2 to -0.5; P = 0.003). No changes in cardiovascular risk factors were observed. Compared with BCS usual care, the BCS exercise group reported improved subjective vitality (mean difference 2.56; 95% CI: 1.22-3.90; P < 0.001) and satisfaction with life (mean difference 1.68; 95% CI: 0.43-2.93; P = 0.009).
Conclusions:
Although aerobic exercise improves CRF in anthracycline-treated long-term BCS, the response was less than one-half that observed in cancer-naive subjects.
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