Supervised Aerobic Training During or After Chemotherapy for Operable Breast Cancer

Inclusion criteria

• Aged 21-80 years
• Female
• MSK histologically confirmed early-stage operable breast cancer
• Scheduled to receive chemotherapy in the neoadjuvant or adjuvant setting
• ECOG status of 0 or 1
• Performing less than 150 minutes of structured moderate-intensity or strenuous intensity exercise per week
• If a female of child-bearing potential, must not be pregnant or planning to become pregnant during the study.

a. Women < 50 years old must have a negative pregnancy test (urine HCG or serum βHCG) within 2 weeks of beginning chemotherapy.

• Able to complete an acceptable baseline cardiopulmonary exercise test (CPET), in the absence of high risk ECG findings or other inappropriate response to exercise as determined by the investigator.
• Able to achieve an acceptable peak baseline CPET, as defined by any of the following criteria:

• Achieving a plateau in oxygen consumption, concurrent with an increase in power output;
• A respiratory exchange ratio ≥ 1.10;
• Attainment of maximal predicted heart rate (HRmax) (i.e., within 10 bpm of age-predicted HRmax [HRmax = 220-Age[years]);
• Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale.
• Willingness to be randomized to one of the study arms

Exclusion criteria

• Presence of any other concurrent, actively treated malignancy
• History of any other malignancy treated within the past 3 years (other than non-melanoma skin cancer)
• Presence of metastatic disease
• Any of the following contraindications to cardiopulmonary exercise testing:
• 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
• Respiratory failure
• Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis) or
• Room air desaturation at rest ≤ 85%
• Mental impairment leading to inability to cooperate.
• Any other condition or intercurrent illness that, in the opinion of the investigator, makes the participant a poor candidate for the trial