Physical Activity in Reducing Metabolic Dysregulation (MetD) in Obese Latina Breast Cancer Survivors

PRIMARY OBJECTIVES:

I. To determine the effects of a 6-month progressive combined training (PCT) program on
metabolic dysregulation (MetD) in centrally obese latina breast cancer survivors (LBCS).

SECONDARY OBJECTIVES:

I. To determine whether improved physical fitness and health-related measures from a 6-month
PCT program are associated with reductions in MetD in centrally obese LBCS.

II. To determine whether MetD status and physical fitness can be maintained following a
6-month follow-up period and to establish predictors of exercise behavior in LBCS.

OUTLINE: Patients are randomized to 1 of 3 groups.

GROUP I (PROGRESSIVE COMBINED TRAINING [PCT]): Patients undergo supervised exercise sessions
comprising of aerobic exercise (AE) over 30 minutes and resistance exercise (RE) over 25
minutes 3 days per week for 24 weeks. Patients are encouraged to complete AE at home over 20
minutes 1 day per week. Patients receive a Polar heart rate monitor to monitor heart rate
during the AE sessions.

GROUP II (PROGRESSIVE AEROBIC TRAINING [PAT]): Patients undergo supervised exercise sessions
comprising of AE over 45-60 minutes 3 days per week for 24 weeks. Patients are encouraged to
complete AE at home over 20 minutes 1 day per week. Patients receive a Polar heart rate
monitor to monitor heart rate during the AE sessions.

GROUP III (USUAL CARE): Patients undergo usual care. Beginning 24 weeks, patients may undergo
supervised exercise sessions comprising of AE and RE as in Group I.

After completion of study, patients are followed up at 37 and 49 weeks.

Inclusion Criteria:

- Newly diagnosed (stage I-III) breast cancer

- Self-identify as Latina

- Have undergone a lumpectomy or mastectomy

- Have received and completed neoadjuvant or adjuvant cytotoxic chemotherapy and/or
radiation therapy within the past 12 months

- Have no evidence of cancer disease after treatment (confirmed by their treating
physician)

- Able to initiate a supervised exercise program (free from any cardiovascular,
respiratory or musculoskeletal disease or joint problems that preclude moderate
physical activity; obtains clearance from physician to confirm status)

- Are centrally obese with the following criteria (determined by study team at
eligibility screening): body mass index (BMI) > 30 kg/m^2 (calculated using height and
weight) or body fat > 30% (estimated by bioelectrical impedance), and waist
circumference > 35 inches (in)

- Free from history of chronic disease including severe diabetes (glycosylated
hemoglobin [HgA1c] > 7% requiring a pharmacologic intervention), uncontrolled
hypertension or thyroid disease (obtains clearance from physician to confirm status)

- Have not experienced a weight reduction >= 10% within past 6 months; and body weight
has remained stable for the past 4 weeks

- Currently participate in less than 60 minutes of physical activity/week

- No planned reconstructive surgery with flap repair during trial and follow-up period

- May use adjuvant endocrine therapy if use will be continued for duration of study
period

- Does not smoke (no smoking during previous 12 months)

- Willing to travel to the exercise facility at University of Southern California (USC)
(parking fees and public transportation permits will be provided)

Exclusion Criteria:

- Currently pregnant

- History of chronic disease including uncontrolled diabetes, uncontrolled hypertension
or uncontrolled thyroid disease; women using metformin to manage diabetes will be
excluded from the trial

- Weight reduction >= 10% within past 6 months

- Metastatic disease

- Planned reconstructive surgery with flap repair during trial and follow-up period

- Cardiovascular, respiratory or musculoskeletal disease or joint problems that preclude
moderate physical activity