Trial Comparing the Effects of Linear Versus Nonlinear Aerobic Training in Women With Operable Breast Cancer

Inclusion Criteria:

- Aged 45-80 years

- Female

- Has been diagnosed with early-stage breast cancer

- Post-menopausal, defined as :

- Age ≥ 45 with no menses for at least 2 years

- Chemically induced menopause through ovarian suppression, as determined by the primary
oncologist

- An interval of at least one year, but no more than five years, following the full
completion of primary therapy for malignant disease. Primary therapy is defined as:

- Surgery plus radiation

- Surgery plus chemotherapy

- Surgery plus trastuzumab

- Surgery plus hormone therapy Note: For patients who receive hormone therapy following
surgery, the definition of one-year post-completion of therapy is defined by the
surgery date. Patients who are currently receiving hormone therapy are eligible for
enrollment.

- Weight of < 205 kgs

- ECOG status of 0 or 1

- Life expectancy ≥ 6 months

- Performing less than 150 minutes of structured moderate-intensity or strenuous
intensity exercise per week.

- Exercise intolerance defined by a VO2peak below that predicted for sedentary age and
sex-matched individuals as defined in Appendix H.

- Willing to be randomized to one of the study arms

- Able to complete an acceptable baseline 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.

Exclusion Criteria:

- Any of the following absolute 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);

- 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

- 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