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Breast Cancer Res Treat. 2018 Feb;167(3):719-729. doi: 10.1007/s10549-017-4554-4. Epub 2017 Nov 6.

The effect of an aerobic exercise bout 24 h prior to each doxorubicin treatment for breast cancer on markers of cardiotoxicity and treatment symptoms: a RCT.

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Department of Biomedical Engineering, University of Alberta, 1098-8308 114 St, Edmonton, T6G 2V2, Canada.
Centre for Heart, Lung and Vascular Health, University of British Columbia, 360 - 1147 Research Road, Kelowna, V1V 1V7, Canada.
Cardiff Centre for Exercise and Health, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Rd, Cardiff, CF23 6XD, UK.
Rehabilitation Sciences, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, V6T 1Z3, Canada.
School of Kinesiology, University of British Columbia, 6081 University Blvd, Vancouver, V6T 1Z1, Canada.
Medical Oncology, British Columbia Cancer Agency, 600 W 10th Ave, Vancouver, V5Z 4E6, Canada.
Department of Medicine, Gordon & Leslie Diamond Health Care Centre 9th Floor, University of British Columbia, 2775 Laurel Street, Vancouver, V5Z 1M9, Canada.
Columbia University Medical Center, 630 West 168th St, New York, 10032, USA.
Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, V6T 1Z3, Canada.



In rodents, a single exercise bout performed 24 h prior to a single doxorubicin treatment provides cardio-protection. This study investigated whether performing this intervention prior to every doxorubicin treatment for breast cancer reduced subclinical cardiotoxicity and treatment symptoms.


Twenty-four women with early stage breast cancer were randomly assigned to perform a 30-min, vigorous-intensity treadmill bout 24 h prior to each of four doxorubicin-containing chemotherapy treatments or to usual care. Established echocardiographic and circulating biomarkers of subclinical cardiotoxicity, as well as blood pressure and body weight were measured before the first and 7-14 days after the last treatment. The Rotterdam symptom checklist was used to assess patient-reported symptoms.


The exercise and usual care groups did not differ in the doxorubicin-related change in longitudinal strain, twist, or cardiac troponin. However, the four total exercise bouts prevented changes in hemodynamics (increased cardiac output, resting heart rate, decreased systemic vascular resistance, p < 0.01) and reduced body weight gain, prevalence of depressed mood, sore muscles, and low back pain after the last treatment (p < 0.05) relative to the usual care group. No adverse events occurred.


An exercise bout performed 24 h prior to every doxorubicin treatment did not have an effect on markers of subclinical cardiotoxicity, but had a positive systemic effect on hemodynamics, musculoskeletal symptoms, mood, and body weight in women with breast cancer. A single exercise bout prior to chemotherapy treatments may be a simple clinical modality to reduce symptoms and weight gain among women with breast cancer.


Breast cancer; Cardiotoxicity; Doxorubicin; Exercise; Treatment symptoms

[Indexed for MEDLINE]

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