Preventing Cardiovascular Complications of Breast Cancer Treatment: The Utility of Effective Exercise Prescription

Abstract

Advances in early detection and adjuvant therapy have led to dramatic improvements in longevity following a cancer diagnosis. As a result, approximately 3 million breast cancer survivors are alive in the US, with this figure projected to increase to 3.7 million in 2022. However, conventional breast cancer therapies (i.e., chemotherapy, radiotherapy, endocrine therapy, HER-2–directed therapies) can lead to important cardiovascular side-effects, particularly cardiovascular disease (CVD). Since adjuvant therapy for breast cancer is curative in the vast majority of scenarios, it is critical to identify strategies that permit maximum antitumor efficacy whilst minimizing acute and long-term toxicities in order to optimize long-term overall survival and quality of life. Here we overview the cardiac and vascular risk toxicities associated with breast cancer adjuvant therapy as well as the extant evidence supporting the efficacy of aerobic exercise training to modify CVD-specific mortality in women with early breast cancer. Such information is important to clinicians and exercise oncology researchers who are developing effective management strategies in long-term cancer survivors.