The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors

BMC Cancer

Kerry S Courneya⁵  Jeff K Vallance⁶  S Nicole Culos-Reed³  Margaret L McNeely⁹  Gordon J Bell⁷  John R Mackey¹  Yutaka Yasui¹⁰  Yan Yuan¹⁰  Charles E Matthews⁴  David CW Lau²  Diane Cook⁷  Christine M Friedenreich⁸ 

[1] Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

[2] Faculty of Medicine, University of Calgary, Calgary, Canada

[3] Faculty of Kinesiology, University of Calgary, Calgary, Canada

[4] Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, Maryland

[5] Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, Canada

[6] Faculty of Health Disciplines, Athabasca University, Athabasca, Canada

[7] Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada

[8] Department of Epidemiology, Alberta Health Services, Calgary, Canada

[9] Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

[10] School of Public Health, University of Alberta, Edmonton, Canada

关键词: Survival;    Recurrence;    Exercise determinants;    Quality of life;    Lymphedema;    Muscular strength;    Cardiorespiratory fitness;    Physical activity;    Exercise;    Breast cancer;   

Others  :  1080086
DOI  :  10.1186/1471-2407-12-525

 received in 2012-09-27, accepted in 2012-11-14,  发布年份 2012

【 摘 要 】

Background

Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the

A

lberta

M

oving

Be

yond B

r

east Cancer (AMBER) Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death.

Methods/Design

The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery), 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes.

Discussion

The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1) the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival), treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy), quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness), (2) the determinants of physical activity and health-related fitness including demographic, medical, social cognitive, and environmental variables, (3) the mediators of any observed associations between physical activity, health-related fitness, and health outcomes including biological, functional, and psychosocial, and (4) the moderators of any observed associations including demographic, medical, and biological/disease factors. Taken together, these data will provide a comprehensive inquiry into the outcomes, determinants, mechanisms, and moderators of physical activity and health-related fitness in breast cancer survivors.

【 授权许可】

   
2012 Courneya et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Canadian Cancer Society's Steering Committee on Cancer Statistics: Canadian Cancer Statistics. Toronto, ON: Canadian Cancer Society 2011; 2011. May 2011 ISSN 0835–2976; 2011
• [2]Ganz PA, Hahn EE: Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol 2008, 26(5):759-767.
• [3]Ballard-Barbash R, Friedenreich C, Courneya K, Siddiqi S, McTiernan A, Alfano C: Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 2012, 104(11):815-840. Epub 2012 May 2018
• [4]Friedenreich CM, Courneya KS, Bryant HE: The lifetime total physical activity questionnaire: development and reliability. Medicine & Science in Sports & Exercise. Med Sci Sports Exerc 1998, 30(2):266-274.
• [5]Friedenreich CM, Courneya KS, Neilson HK, Matthews CE, Willis G, Irwin M, Troiano R, Ballard-Barbash R: Reliability and validity of the past year total physical activity questionnaire. Am J Epidemiol 2006, 163(10):959-970.
• [6]Lynch BM: Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomarkers Prev 2010, 19(11):2691-2709. Epub 2010 Sep 10 Review
• [7]Edge SB, Byrd DR, Compton CC (Eds): Breast In AJCC Cancer Staging Manual. 7th edition. New York, NY: Springer; 2010:347-376.
• [8]Warburton D, Jamnik V, Bredin S, Gledhill N: The physical activity readiness questionnaire (PAR-Q+) and electronic physical activity readiness medical examination (ePARmed-X+). Health & Fitness Journal of Canada 2011, 4(2):3-23.
• [9]Bryant H, Robson P, Ullman R, Friedenreich C, Dawe U: Population-based cohort development in Alberta, Canada: a feasibility study. Chronic Dis Can 2006, 27(2):51-59.
• [10]Ainsworth B, Haskell W, Herrmann S, Meckes N, Bassett DJ, Tudor-Locke C, Greer J, Vezina J, Whitt-Glover M, Leon A: 2011 Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 2011, 43(8):1575-1578.
• [11]Marshall A, Miller Y, Burton N, Brown W: Measuring total and domain-specific sitting: a study of reliability and validity. Med Sci Sports Exerc. Med Sci Sports Exerc 2010, 42(6):1094-1102.
• [12]Csizmadi I, Kahle L, Ullman R, Dawe U, Zimmerman TP, Friedenreich CM, Bryant H, Subar AF: Adaptation and evaluation of the National Cancer Institute's Diet History Questionnaire and nutrient database for Canadian populations. Public Health Nutr 2007, 10(1):88-96.
• [13]Subar AF, Thompson FE, Kipnis V, Midthune D, Hurwitz P, McNutt S, McIntosh A, Rosenfeld S: Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires: the Eating at America's Table Study.[see comment]. Am J Epidemiol 2001, 154(12):1089-1099.
• [14]Bullo M, Casas-Agustench P, Amigo-Correig P, Aranceta J, Salas-Salvado J: Inflammation, obesity and comorbidities: the role of diet. Public Health Nutr 2007, 10(10A):1164-1172.
• [15]Ware J: SF-36 Health Survey: Manual and Interpretation Guide. Boston, MA: The Health Institute, New England Medical Centre; 1993.
• [16]Ware J: SF-36 Physical and Mental Health Summary Scales: A User's Manual. Boston, MA: The Health Institute, New England Medical Centre; 1994.
• [17]Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J, et al.: The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 1993, 11(3):570-579.
• [18]Cella D: The functional assessment of cancer therapy-anemia (FACT-An) scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol 1997, 34(3 Suppl 2):13-19.
• [19]Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE: Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage 2002, 24(6):547-561.
• [20]Kroenke K, Spitzer R, Williams J: The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001, 16(9):606-613.
• [21]Diener E, Emmons RA, Larsen RJ, Griffin S: The Satisfaction with Life Scale. J Person Assess 1985, 49:71-75.
• [22]Fordyce MW: A review of research on the happiness measures: a sixty second index of happiness and mental health. Soc Indic Res 1988, 20:355-381.
• [23]Ajzen I: The theory of planned behavior. Organ Behav Hum Dec 1991, 50:179-211.
• [24]Stevinson C, Tonkin K, Capstick V, Schepansky A, Ladha A, Valance J, Faught W, Steed H, Courneya K: A population-based study of the determinants of physical activity in ovarian cancer survivors. J Phys Act Health 2009, 6(3):339-346.
• [25]Karvinen KH, Courneya KS, Campbell KL, Pearcey RG, Dundas G, Capstick V, Tonkin KS: Correlates of exercise motivation and behavior in a population-based sample of endometrial cancer survivors: An application of the theory of planned behavior. Int J Behav Nutr Phys Act 2007, 4:21. BioMed Central Full Text
• [26]Trinh L, Plotnikoff R, Rhodes R, North S, Courneya K: Correlates of physical activity in population-based sample of kidney cancer survivors: an application of the theory of planned behavior. Int J Behav Nutr Phys Act 2012, 9(1):96. [Epub ahead of print] BioMed Central Full Text
• [27]Choi L, Liu Z, Matthews C, Buchowski M: Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc 2011, 43(2):357-364.
• [28]Matthews C, Hagströmer M, Pober D, Bowles H: Best practices for using physical activity monitors in population-based research. Med Sci Sports Exerc 2012, 44(1 Suppl 1):S68-S76.
• [29]Freedson P, Lyden K, Kozey-Keadle S, Staudenmayer J: Evaluation of artificial neural network algorithms for predicting METs and activity type from accelerometer data: validation on an independent sample. J Appl Physiol 2011, 111(6):1804-1812. Epub 2011 Sep 1801
• [30]The Canadian Physical Activity, Fitness & Lifestyle Approach (CPAFLA). Canadian Society for Exercise Physiology. 3rd edition. Ottawa: Public Health Agency of Canada; 2003.
• [31]Borg E, Kaijser L: A comparison between three rating scales for perceived exertion and two different work tests. Scand J Med Sci Sports 2006, 16:57-69.
• [32]McInnis K, Balady G: Comparison of submaximal exercise responses using the Bruce vs modified Bruce protocols. Med Sci Sports Exerc 1994, 26(1):103-107.
• [33]Beaver W, Wasserman K, Whip B: A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 1986, 60(6):2020-2027.
• [34]Strength N, Asscociation C: Essentials of Strength Training and Conditioning. 3rd edition. Windsor Ontario: Human Kinetics; 2008.
• [35]Mayhew J, Ball T, Arnold M, Bowen J: Relative muscular endurance performance as a predictor of bench press strength in college men and women. J Appl Sports Sci Res 1992, 6:200-206.
• [36]Faulkner R, Sprigings E, McQuarrie A, Bell R: A partial curl-up protocol for adults based on an analysis of two procedures. Can J Sport Sci 1989, 14(3):135-141.
• [37]Armer JM: The problem of post-breast cancer lymphedema: impact and measurement issues. Cancer Invest 2005, 23(1):76-83.
• [38]Stanton AW, Northfield JW, Holroyd B, Mortimer PS, Levick JR: Validation of an optoelectronic limb volumeter (Perometer). Lymphology 1997, 30(2):77-97.
• [39]Norkin CN, White DJ: Measurement of Joint Motion: A Guide to Goniometry. Philadelphia: FA Davis Company; 1995.
• [40]Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C: Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther 2001, 14(2):128-146.
• [41]Friedenreich CM, Kopciuk KA, Mackey JR, Gregory J, Courneya KS: Prospective cohort study of lifetime physical activity and breast cancer survival. Int J Cancer 2009, 124:1954-1962.
• [42]Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, Ladha AB, Proulx C, Vallance JK, Lane K, et al.: Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 2007, 25(28):4396-4404.
• [43]Hudis CA, Barlow WE, Costantino JP, Gray RJ, Pritchard KI, Chapman JA, Sparano JA, Hunsberger S, Enos RA, Gelber RD, et al.: Proposal for standardized definitions for efficacy end points in adjuvant breast cancer trials: the STEEP system. J Clin Oncol 2007, 25(15):2127-2132.
• [44]Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M: ATAC Trialists' Group. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial.[see comment]. Lancet Oncol 2008, 9(1):45-53.
• [45]Early Breast Cancer Trialists' Collaborative Group E: Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials.[see comment]. Lancet 2005, 365(9472):1687-1717.
• [46]Thurlimann B, Keshaviah A, Coates AS, Mouridsen H, Mauriac L, Forbes JF, Paridaens R, Castiglione-Gertsch M, Gelber RD, Rabaglio M, et al.: Breast International Group 1–98 Collaborative, Group. A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer.[see comment][erratum appears in N Engl J Med. 2006 May 18;354(20):2200 Note: Wardly, Andrew [corrected to Wardley, Andrew]]. N Eng J Med 2005, 353(26):2747-2757.
• [47]Neilson HK, Friedenreich CM, Brockton NT, Millikan RC: Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev 2009, 18(1):11-27.
• [48]Monninkhof EM, Velthuis MJ, Peeters PH, Twisk JW, Schuit AJ: Effect of exercise on postmenopausal sex hormone levels and role of body fat: a randomized controlled trial. J Clin Oncol 2009, 27(27):4492-4499.
• [49]Friedenreich C, Woolcott C, McTiernan A, Ballard-Barbash R, Brant R, Stanczyk F, Terry T, Boyd N, Yaffe M, Irwin M, et al.: Alberta physical activity and breast cancer prevention trial: sex hormone changes in a year-long exercise intervention among postmenopausal women. J Clin Oncol 2010, 28(9):1458-1466. Epub 2010 Feb 1416
• [50]Friedenreich CM, McTiernan A, Woolcott CG, Terry TB RF, Ballard-Barbash R, Campbell KL, McNeely ML, Karvinen KH, Boyd NF, Yaffe MJ, et al.: Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes 2011, 35(3):427-435.
• [51]Schmitz KH, Ahmed RL, Hannan PJ, Yee D: Safety and efficacy of weight training in recent breast cancer survivors to alter body composition, insulin, and insulin-like growth factor axis proteins. Cancer Epidemiol Biomarkers Prev 2005, 14(7):1672-1680.
• [52]Tsavaris N, Kosmas C, Vadiaka M, Kanelopoulos P, Boulamatsis D: Immune changes in patients with advanced breast cancer undergoing chemotherapy with taxanes. Br J Cancer 2002, 87(1):21-27.
• [53]Peel JB, Sui X, Adams SA, Hebert JR, Hardin JW, Blair SN: A prospective study of cardiorespiratory fitness and breast cancer mortality. Med Sci Sports Exerc 2009, 41(4):742-748.
• [54]Browall M, Ahlberg K, Karlsson P, Danielson E, Persson LO, Gaston-Johansson F: Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women. Eur J Oncol Nurs 2008, 12(3):180-189.
• [55]Ganz PA, Guadagnoli E, Landrum MB, Lash TL, Rakowski W, Silliman RA: Breast cancer in older women: quality of life and psychosocial adjustment in the 15 months after diagnosis. J Clin Oncol 2003, 21(21):4027-4033.
• [56]Ganz PA, Kwan L, Stanton AL, Krupnick JL, Rowland JH, Meyerowitz BE, Bower JE, Belin TR: Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst 2004, 96(5):376-387.
• [57]Ganz PA: Impact of tamoxifen adjuvant therapy on symptoms, functioning, and quality of life. J Natl Cancer Inst 2001, 30:130-134. Monographs
• [58]Meeske K, Smith AW, Alfano CM, McGregor BA, McTiernan A, Baumgartner KB, Malone KE, Reeve BB, Ballard-Barbash R, Bernstein L: Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report. Qual Life Res 2007, 16(6):947-960.
• [59]Trentham-Dietz A, Sprague BL, Klein R, Klein BE, Cruickshanks KJ, Fryback DG, Hampton JM: Health-related quality of life before and after a breast cancer diagnosis. Breast Cancer Res Treat 2008, 109(2):379-387.
• [60]Kenne Sarenmalm E, Odén A, Joakim O, Gaston-Johansson F, Holmberg SB: Changes in health-related quality of life may predict recurrent breast cancer. Eur J Oncol Nurs 2009, 13(5):323-329. Epub 2009 Jul 2012
• [61]McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS: Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 2006, 175(1):34-41.
• [62]Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH: An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2010, 4(2):87-100.
• [63]Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS: Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes.[see comment]. J Clin Oncol 2003, 21(9):1660-1668.
• [64]Courneya KS, Sellar CM, Stevinson C, McNeely ML, Peddle CJ, Friedenreich CM, Tankel K, Basi S, Chua N, Mazurek A, et al.: Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol 2009, 27(27):4605-4612.
• [65]Petrek JA, Senie RT, Peters M, Rosen PP: Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. Cancer 2001, 92(6):1368-1377.
• [66]Clark B, Sitzia J, Harlow W: Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005, 98(5):343-348.
• [67]Hayes S, Johansson K, Stout N, Prosnitz R, Armer J, Gabram S, Schmitz K: Upper-body morbidity after breast cancer: incidence and evidence for evaluation, prevention, and management within a prospective surveillance model of care. Cancer 2012, 118(8 Suppl):2237-2249.
• [68]Sclafani LM, Baron RH: Sentinel lymph node biopsy and axillary dissection: added morbidity of the arm, shoulder and chest wall after mastectomy and reconstruction. Cancer J 2008, 14(4):216-222.
• [69]Ahmed RL, Prizment A, Lazovich D, Schmitz KH, Folsom AR: Lymphedema and quality of life in breast cancer survivors: the Iowa Women's Health Study. J Clin Oncol 2008, 26(35):5689-5696.
• [70]Paskett ED, Naughton MJ, McCoy TP, Case LD, Abbott JM: The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomarkers Prev 2007, 16(4):775-782.
• [71]Hayes SC, Janda M, Cornish B, Battistutta D, Newman B: Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol 2008, 26(21):3536-3542.
• [72]Thomas-Maclean RL, Hack T, Kwan W, Towers A, Miedema B, Tilley A: Arm morbidity and disability after breast cancer: new directions for care. Oncology Nursing Forum Online 2008, 35(1):65-71.
• [73]Stubblefield M, Burstein H, Burton A, Custodio C, Deng G, Ho M, Junck L, Morris G, Paice J, Tummala S, et al.: NCCN task force report: management of neuropathy in cancer. J Natl Compr Canc Netw 2009, 7(Suppl 5):S1-S26. quiz S27-8. Review
• [74]Stubblefield M, McNeely M, Alfano C, Mayer D: A prospective surveillance model for physical rehabilitation of women with breast cancer: chemotherapy-induced peripheral neuropathy. Cancer 2012, 118(8 Suppl):2250-2260.