Exercise Testing for Early Stage Breast Cancer Patients Receiving Radiation Treatment

Inclusion criteria

• Female
• ECOG performance status 0 or 1
• Medical clearance from attending radiation oncologist or medical oncologist to undergo a symptom-limited CPET
• Currently undergoing intact breast radiotherapy for early stage breast cancer (including TisN0, T1N0, T2N0) or has completed intact breast RT in the last 3 months.
• Receiving or received a prescribed dose of 4240 cGy in 16 fractions to the whole breast without treatment directed at nodal basins. Patients may also be receiving or have received a boost to the lumpectomy bed at the discretion of the treating physician.
• Subjects may be treated in the supine or prone position at the discretion of the treating physician.
• Subjects may be treated with or without a deep inspiratory breath hold technique at the discretion of the treating physician.
• Identified by the treating radiation oncologist as having significant treatment-related fatigue or minimal treatment-related fatigue and not simply baseline fatigue. A score of "0" on the RTOG fatigue scale will be considered minimal fatigue, while a score of "2" or greater will be considered significant fatigue (moderate fatigue causing difficulty performing some ADLs).

Exclusion criteria

• Currently undergoing post-mastectomy radiation
• Has received chemotherapy previously or has a plan to receive chemotherapy during the timeframe of study assessment.
• Any of the following absolute contraindications to CPET, as per American Thoracic Society (ATS) recommendations

• Acute myocardial infarction (within 3-5 days of any planned study procedures)
• Unstable angina
• Uncontrolled arrhythmia causing symptoms or hemodynamic compromise
• Recurrent syncope
• Active endocarditis
• Acute myocarditis or pericarditis
• Symptomatic severe aortic stenosis
• Uncontrolled heart failure
• Acute pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures
• Thrombosis of lower extremities
• Suspected dissecting aneurysm
• Uncontrolled asthma
• Pulmonary edema
• Room air desaturation at rest ≤ 85%
• Respiratory failure
• Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (i.e. infection, renal failure, thyrotoxicosis)
• Mental impairment leading to inability to cooperate