Fitness during Breast Cancer Treatment and Recovery in an Athlete: A Case Study.

Purpose: This is a case study of an aerobically trained, multi-sport, female athlete (age = 39) diagnosed with stage IIIc human epidermal growth factor receptor 2 positive breast cancer. The focus of the study is on measures of cardiorespiratory fitness (VO2peak) through the course of cancer therapy. Methods: A symptom-limited cardiopulmonary exercise tolerance test was performed to determine VO2peak. The test were performed at 5 different time points; 1) at diagnosis of breast cancer and prior to initiating chemotherapy, 2) after completion of chemotherapy (5-months post diagnosis), 3) 2 1/2 months after bilateral mastectomy surgery (9-months post diagnosis), 4) immediately following radiation therapy (11-months post diagnosis), 5) recovery (32 months post diagnosis). Results: At diagnosis and prior to initiating chemotherapy VO2peak was 50.1 mLO2*min-1*kg-1. The most precipitous decline in fitness, approximately 14%, was observed during the period of time from initial diagnosis through the completion of chemotherapy. The subject regained 9% of her fitness after chemotherapy, despite an intervening mastectomy surgery. Radiation therapy was associated with an approximately 4% decline in fitness from her post-mastectomy surgery value. Ultimately, 32 months after diagnosis and 22 months following the completion of radiation therapy, the subject was able to regain pretreatment fitness levels. Conclusion: The results of the case study describe the effects of undergoing extensive breast cancer therapy on measures of VO2peak for a highly aerobically trained, multi-sport athlete. In this case, exercise training reversed the decrement in measured VO2peak that occurred during cancer therapy. (C) 2016 American College of Sports Medicine

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