Activity In Breast Cancer Survivors Research Articles

2 Mini Oral - The effect of pain neuroscience education and behavioural graded activity in breast cancer survivors: a randomised controlled multi-center trial

2 Mini Oral - The effect of pain neuroscience education and behavioural graded activity in breast cancer survivors: a randomised controlled multi-center trial

“OPERATION PHALCO”—Adapted Physical Activity for Breast Cancer Survivors: Is It Time for a Multidisciplinary Approach?

The international literature emphasizes the importance of physical activity (PA) in the first steps after cancer surgery. The regular practice of physical exercise causes positive adaptations on several functional capacities, with positive consequences on patients' quality of life. This project aims to evaluate the effect of a post-operative training protocol, structured by taking into account both cancer-related issues and the presence of comorbidities, on functional capacities and quality of life of breast cancer survivors. Therefore, it was necessary to create a synergy between oncologists (referring physicians), sport medicine physicians (risk stratification and exercise prescription) and kinesiologists (trainers). Thirty-five post-surgery BC patients decided on a voluntary basis to attend an online Adapted PA (APA) protocol for 4 months, twice a week (APA Group) or Usual Care Group (UC Group). Functional capacity of the APA Group significantly increased, by 13.1% (p = 0.000), whereas perceived exertion decreased by 19.7% (p = 0.020). In the same group, the general health evaluated through the questionnaire EORTC-QLQ-C30 increased (p = 0.050). No differences were found in the UC Group. Operation Phalco, creating a network between oncologists, sports medicine physicians and kinesiologists, confirms the importance of structuring a post-operative path where APA should be included as early as possible in the cancer patient care.

How the COVID-19 pandemic has affected eating habits and physical activity in breast cancer survivors: the DianaWeb study

PurposeBreast cancer (BC) survivors are increasingly interested in learning about healthy lifestyles to reduce the risk of BC recurrence and mortality. The DianaWeb study, a community-based participatory research, offers BC patients a specific interactive website to help them in adopting and maintain correct lifestyles, in line with World Cancer Research Fund recommendations. However, to limit the spread of the COVID-19 pandemic, most countries introduced restrictions which, inevitably, caused sudden lifestyle changes.The current study aimed at evaluating changes in lifestyle in BC survivors before, during, and after the first two waves of the COVID-19 pandemic.MethodsWe used data of 224 BC cancer survivors enrolled in the DianaWeb study. We evaluated the adherence to physical activity (PA) guidelines, to Mediterranean diet (MD), and WCRF recommendations, at baseline, during and after the first two waves of the COVID-19 pandemic. We estimated the association between PA, MD, and WCRF adherence with sociodemographic characteristics, years from enrolment in the DianaWeb study, and type of breast cancer.ResultsAs expected, during confinement periods, we observed a significant decrease in walking activity and in the percentage of patients performing vigorous PA. In post-quarantine, total weekly energy expenditure increased significantly. BC patients participating in the DianaWeb study for more than 3 years were more likely to be more active. There were no changes in MD and WCRF adherence.ConclusionsOur results show that the proposed interactive website was useful in achieving durable lifestyle changes, that have not been undermined either during the COVID-19 pandemic.Implications for Cancer SurvivorsPatient education is essential for guiding BC survivors toward improving their health outcomes; therefore, an interactive website like the one proposed by the DianaWeb study may be useful to improve healthy lifestyles.

Experience of Physical Activity in Breast Cancer Survivors: A Qualitative Study.

Physical activity plays an important role in the recovery of breast cancer survivors. However, previous studies have shown that most breast cancer survivors have inadequate levels of physical activity. This study aimed to explore the influencing factors of physical activity in breast cancer survivors. Twelve participants aged 38 to 65 years who had completed surgery and related treatment for breast cancer were recruited from the outpatient service of a hospital in Daqing, China. The phenomenological method was used in this qualitative research. Semistructured interviews were conducted to explore the influencing factors of physical activity in breast cancer survivors. Colaizzi's 7-step analysis method was used to code the data and identify descriptive themes. Four themes affecting the daily physical activity of breast cancer patients were extracted: perception and motivation (knowledge about benefits, goals, and motivation for physical activity), symptom burden (psychological and physical symptoms), social support (support from oncology staff, family, and peers) and environmental resources (seasonal impact, community resources). The physical activity of breast cancer survivors is affected by many factors. Oncology providers need to strengthen assessment, identify barriers, and provide interventions to promote the patients' participation in physical activity and to improve their quality of life. It is necessary for providers to integrate medical and social support resources, use strategies to enhance motivation, and effectively solve barriers to increase physical activity in breast cancer survivors.

A digital health intervention to improve nutrition and physical activity in breast cancer survivors: Rationale and design of the Cook and Move for Your Life pilot and feasibility randomized controlled trial

BackgroundThe design of a randomized pilot trial evaluating the feasibility of two doses of a digital health intervention promoting changes in nutrition and physical activity in breast cancer (BC) survivors is described. MethodsEligible women were adults with history of early-stage breast cancer and > 60 days post-treatment, consumed <5 servings/day of fruits/vegetables and/or engaged in <150 min/week of aerobic moderate-to-vigorous physical activity, and had internet access. Participants were randomized to 6 months of either a “low” (1 session) or “high” (12 sessions) dose digital health intervention. Zoom-delivered sessions focused on improving diet and physical activity through didactic and experiential classes delivered by a registered dietitian, chef, exercise physiologist, and culinary educator. All study participants received weekly motivational texts, a Fitbit, and study website access. Diet, accelerometry, anthropometric, psychosocial, and biospecimen data were collected remotely at baseline and six months. Primary outcome was feasibility measured via accrual rate, adherence, retention, and acceptability. ResultsRecruitment began in December 2019, was suspended in March 2020 due to the COVID-19 pandemic, resumed September 2020, and concluded in January 2021. Women were identified from the local BC registry and flyers posted in the oncology clinic. Of 929 women recruited, 321 completed the screening assessment, and of these, 138 were eligible. A total of 74 women were enrolled and randomized to the study. ConclusionBC survivors were successfully enrolled in a digital health nutrition and physical activity intervention. If feasible, this intervention will be tested in larger and more diverse populations of cancer survivors.Trial registration:ClinicalTrials.govNCT04200482

Factors predicting long-term physical activity of breast cancer survivors. 5-year-follow-up of the BREX exercise intervention study

Background The benefits of exercise training are well documented among breast cancer (BC) survivors. Patients decrease their physical activity during treatment, and many fail to regain their previous exercise levels. There is therefore a need to define factors supporting long-term physical activity behavior in this patient group, to target supporting interventions aimed at preventing the decline in physical activity (PA). Aim The aim of this study was to determine physical and psychosocial factors explaining long-term physical activity after the adjuvant treatments in BC survivors. Methods Four-hundred forty-six BC survivors followed for 5-years within a randomized exercise trial participated. Factors explaining (1) physical activity after the adjuvant treatments and (2) changes in physical activity in long-term were analyzed using linear regression models and general estimating equation models. Pretreatment leisure-time physical activity (LTPA), demographic, and treatment factors, physical fitness, and quality of life (Qol) at baseline were independent factors. Results Exercise levels increased during the first year, and thereafter remained mostly stable. Higher LTPA, higher fitness level, better Qol and older age at baseline were associated with higher physical activity level after adjuvant treatments (p < .001) in multivariate analysis. Higher levels of fatigue (p < .008) and better emotional functioning (p = .017) at baseline were the main factors associated with increased physical activity during the follow-up. Conclusion Previous exercise habits and Qol after adjuvant chemo-, and radiotherapy were the strongest determinants of long-term physical activity levels in breast cancer survivors. Patients with better emotional functioning increased their exercise activity most as did those patients with higher fatigue levels at baseline. Patients suffering from fatigue after adjuvant treatment managed to increase their exercise levels, in contrast to patients with low emotional functioning, and may benefit from physical exercise interventions. Emotionally deprived patients may benefit from psychosocial support to regain their previous exercise levels.

Personality and Spirituality as Predictors of Mental Health and Salivary Alpha-Amylase Activity in Breast Cancer Survivors.

To determine the relative predictive validity of personality and spirituality for mental health and salivary alpha-amylase (sAA) in breast cancer (BC) survivors. 23 BC survivors participated in a single-group, cross-sectional study. Predictor variables included personality and spiritual variables. Outcome variables included subjective physical and mental health outcomes and sAA, a neuroimmune biomarker. Hierarchical regressions indicated that (a) conscientiousness and forgiveness independently predict 38% and 11% of variance in mental health scores, respectively; and (b) conscientiousness and forgiveness independently predict 15% and 24% of the variance in sAA, respectively. Consistent with psychoneuroimmunology theory, personality and spiritual variables independently influence subjective mental health and neuroimmune activity in BC survivors. Nurses should be aware of BC survivors' personality characteristics and spiritual dispositions so that distinct interventions can be offered to promote mental health and reduce stress-related neuroimmune inflammation.

A Digital Health Intervention to Improve Nutrition and Physical Activity in Breast Cancer Survivors: Rationale and Design of the Cook and Move for Your Life Pilot Randomized Controlled Trial

A Digital Health Intervention to Improve Nutrition and Physical Activity in Breast Cancer Survivors: Rationale and Design of the Cook and Move for Your Life Pilot Randomized Controlled Trial

Increasing Physical Activity among Breast Cancer Survivors by Modulating Temporal Orientation with rTMS: Feasibility and Potential Efficacy.

Maintaining adequate amounts of physical activity is a critical component of survivorship care for women with breast cancer. Increased physical activity is associated with increases in well-being, quality of life, and longevity, but women with cancer face unique, cancer-related factors that might affect physical activity. Consistent with the Competing Neurobehavioral Decision Systems model of decision making, we proposed to decrease delay discounting and increase physical activity by stimulating the executive function system via high-frequency repetitive transcranial magnetic stimulation (HF rTMS) of the left dorsolateral prefrontal cortex (LDLPFC). This randomized, sham-controlled, double-blinded trial examined the feasibility and potential efficacy of this approach to increase physical activity in breast cancer survivors. We hypothesized that active rTMS would significantly increase the mean number of steps per day and decrease delay discounting. Participants (n = 30) were primarily middle-aged (M = 53.7, SD = 7.9) and white with a mean BMI and body mass indices below 40. Indicators of feasibility and limited efficacy testing were positive. Although repeated-measures ANOVA revealed no significant changes in delay discounting, generalized estimating equations (GEE) found that participants in the active condition increased their mean daily steps by 400 steps per day, while those in the sham condition decreased this by nearly 600 steps per day. These findings indicate that the continued investigation of HF rTMS for increasing physical activity among women with breast cancer is justified.

Active Living After Cancer: Adaptation and evaluation of a community-based physical activity program for minority and medically underserved breast cancer survivors.

BackgroundAn expanding body of research documents the benefits of physical activity for cancer survivors' physical functioning and quality of life, but few successful models provide community‐based physical activity programs to cancer survivors. This report presents an evaluation of Active Living After Cancer, an evidence‐based physical activity program for breast cancer survivors, adapted for community delivery to minority and medically underserved survivors.MethodsSurvivors were recruited from health care and community settings. The program consisted of 12 weekly group sessions providing training in cognitive and behavioral skills for behavior change, brief physical activity, and cancer survivorship‐related content. At the baseline and follow‐up, participants completed assessments of their physical activity, quality of life, and physical functioning (6‐minute walk and 30‐second sit‐to‐stand test). At follow‐up, they also completed questionnaires to measure program content mastery and satisfaction.ResultsThe outcome analysis included 127 participants. Physical activity and quality of life (mental and physical) improved from the baseline to follow‐up (all P < .01). Physical functioning improved, with increases in sit‐to‐stand repetitions (mean, 12.5 at the baseline vs 14.9 at the follow‐up; P < .01) and 6‐minute walk distances (mean, 428 m at the baseline vs 470 m at the follow‐up; P < .01).ConclusionsThe results highlight the effectiveness of an evidence‐based program adapted for community‐based delivery to minority and medically underserved breast cancer survivors. The program could be delivered to improve outcomes in diverse survivor populations.Lay Summary Physical activity in breast cancer survivors is related to better quality of life and longer cancer‐free survival. However, there are few community‐based programs to help breast cancer survivors to become more physically active.The Active Living After Cancer program was adapted from an evidence‐based program and delivered in community‐based settings to minority and medically underserved breast cancer survivors. It consisted of 12 weekly group sessions in which participants learned skills to increase their physical activity.The program participants increased their physical activity and improved their mental and physical well‐being and physical functioning.

User-centered development of a smartphone application (Fit2Thrive) to promote physical activity in breast cancer survivors.

Increased moderate and vigorous physical activity (MVPA) is associated with better health outcomes in breast cancer survivors; yet, most are insufficiently active. Smartphone applications (apps) to promote MVPA have high scalability potential, but few evidence-based apps exist. The purpose is to describe the testing and usability of Fit2Thrive, a MVPA promotion app for breast cancer survivors. A user-centered, iterative design process was utilized on three independent groups of participants. Two groups of breast cancer survivors (group 1 n = 8; group 2: n = 14) performed app usability field testing by interacting with the app for ≥3 days in a free-living environment. App refinements occurred following each field test. The Post-Study System Usability Questionnaire (PSSUQ) and the User Version Mobile Application Rating Scale (uMARS) assessed app usability and quality on a 7- and 5-point scale, respectively, and women provided qualitative written feedback. A third group (n = 15) rated potential app notification content. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using a directed content analysis. The PSSUQ app usability score (M1= 3.8; SD = 1.4 vs. M2= 3.2; SD = 1.1; lower scores are better) and uMARS app quality score (M1 = 3.4; SD = 1.3 vs. M2= 3.4; SD = 0.6; higher scores are better) appeared to improve in Field Test 2. Group 1 participants identified app "clunkiness," whereas group 2 participants identified issues with error messaging/functionality. Group 3 "liked" 53% of the self-monitoring, 71% of the entry reminder, 60% of the motivational, and 70% of the goal accomplishment notifications. Breast cancer survivors indicated that the Fit2Thrive app was acceptable and participants were able to use the app. Future work will test the efficacy of this app to increase MVPA.

Motivational strategies to improve adherence to physical activity in breast cancer survivors: A systematic review and meta-analysis

Two behavioral change-based strategies for promoting adherence to physical activity (PA) suggested to have the greatest potential are the pedometer and Motivational Interviewing (MI). However, there are no comparisons between these two strategies identifying which one is more effective for improving PA adherence. This systematic review and meta-analysis aimed to determine which PA motivation strategy is more effective for promoting adherence to self-directed PA in female breast cancer survivors. Studies implementing self-directed PA which used a step tracker and/or MI for motivation in female breast cancer survivors were identified from the following databases at two timepoints, September 2019 and June 2020: CENTRAL, PubMed, CINAHL, PsycINFO, and Sportdiscuss. Sixteen randomized controlled trials (RCTs) were selected for data extraction, whereas ten RCTs were included in meta-analysis. Meta-analysis was performed on pooled data to estimate the standardized mean differences in PA duration and step count, and 95% confidence intervals. The number of participants meeting PA recommendations was also analyzed. Subgroup analysis was performed for three motivational strategies (pedometer combined with counselling, with print material or with motivational interviewing). Meta-analysis showed that pedometer combined with another intervention has a small effect on step count (p = 0.03) and a moderate effect on duration of moderate-vigorous physical activity (MVPA) (p = <0.0001) compared to controls. Additionally, motivational strategies increase the number of participants who meet a PA goal (p = 0.005). The findings of this review endorse the use of a step tracker combined with counselling, print material or MI based on behavioral change theory. This approach provided the most consistent positive effect on adherence to self-directed PA among breast cancer survivors. Future studies should evaluate differences between measures of adherence to self-directed PA, to identify the best motivation strategy for improving patient adherence and health outcomes.Systematic review registration: PROSPERO Registration number CRD42020148542

Integrating Self-determination Theory and Upper Limb Factors to Predict Physical Activity in Patients With Breast Cancer During Chemotherapy.

Some empirical investigations try to describe the factors that affect the physical activity of breast cancer survivors, but these investigations rarely focus on the basic psychological needs or motivation regulation of breast cancer survivors in physical activity. The aim of this study was to construct structural equation modeling of the self-determination theory and upper limb factors to predict the physical activity of breast cancer patients during chemotherapy. A total of 236 breast cancer survivors completed measures of basic psychological needs, behavioral regulation in exercise, symptoms and dysfunction of upper limb factors, and physical activity. Path analyses structured the direct and indirect effects (via motivational orientations) of basic psychological needs and upper limb factors on physical activity. A total of 216 (91.5%) participants met the standard physical activity metabolic equivalent recommended. The final model has a good degree of fit (χ2 = 809.363, df = 391, χ2/df ≤ 2.07 [1-3]; root-mean-square error of approximation, 0.067 [<0.008]). The competence (0.309) of basic psychological needs and amotivation (-0.38) of motivation regulations have the greatest effect on physical activity. Competence is the most important basic psychological need of breast cancer patients during chemotherapy, and amotivation is the most important motivation regulation. Nurses need to pay more attention to the basic psychological needs and the motivation regulation in breast cancer patients during chemotherapy. Randomized controlled trials of breast cancer survivor interventions based on the self-determination theory are needed.

Determinants of Health and Physical Activity Levels Among Breast Cancer Survivors During the COVID-19 Pandemic: A Cross-Sectional Study.

BackgroundIncreased exercise and physical activity levels are recommended throughout cancer therapy and survivorship. Nonetheless, the COVID-19 pandemic and consequent social distancing are likely to cause a decline in physical activity.Objectiveto evaluate the level of unsupervised physical activity of breast cancer survivors during the COVID-19 pandemic, and the factors associated with difficulties in engaging and maintaining recommended physical activity levels.MethodsThis is a cross-sectional epidemiological study with a sample of 37 breast cancer survivors. They participated in a canoeing training program (project Remama) at the University of São Paulo before the COVID-19 pandemic. Socioeconomic aspects, engagement in physical activity, motivation, and potential exposure to COVID-19 were investigated through an online survey, administered in September of 2020.ResultsDuring the pandemic, participants increased their body weight (5 ± 3.4 kg); 90% reported decreasing physical activity levels associated with increased sedentary time. Twenty-one (58%) participants exhibited some COVID-19-related symptoms, most used public transportation (59%), or returned to work during the period of a high incidence of COVID-19. The only factor associated with perceived difficulty in engaging in physical activities was having had more than three cancer treatments (RR: 2.14; 95% CI: 1.07–4.27).ConclusionThe COVID-19 pandemic led to a group of previously active breast cancer survivors to decrease their physical activity, gain weight, and have sedentary behavior. Specific tailored-care interventions are needed to prevent these occurrences, as overweight and physical inactivity may impose an additional risk for breast cancer recurrence and a severe course of COVID-19 in cancer patients.

Mindfulness-based stress reduction alters brain activity for breast cancer survivors with chronic neuropathic pain: preliminary evidence from resting-state fMRI

Breast cancer continues to be the most commonly diagnosed cancer among Canadian women, with as many as 25-60% of women suffering from chronic neuropathic pain (CNP) as a pervasive consequence of treatment. While pharmacological interventions have shown limited efficacy for the management of CNP to date, psychological interventions, such as mindfulness-based stress reduction (MBSR), may be a promising alterative for improving pain-related problems. The purpose of this study was to use brain imaging methods to investigate this potential. Resting-state fMRI was used in female breast cancer survivors with CNP before and after an 8-week MBSR course (n = 13) and compared with a waitlist control group (n = 10). Focusing on the default mode network, the most significant results show greater posterior cingulate connectivity with medial prefrontal regions post-MBSR intervention. Moreover, this change in connectivity correlated with reduced pain severity for the MBSR group. These results provide empirical evidence of a change in the brain following MBSR intervention associated with changes in the subjective experience of pain. This study gives hope for a non-invasive method of easing the struggle of CNP in women following breast cancer treatment.

Wellness Coaching: An Intervention to Increase Healthy Behavior in Breast Cancer Survivors

Regular physical activity after breast cancer diagnosis improves survival rates and quality of life (QOL). However, breast cancer survivors rarely meet guidelines for recommended levels of physical activity. Wellness coaching interventions (WCIs) have improved exercise and health behaviors in other patient populations. This study assessed the feasibility and effectiveness of WCIs for increasing physical activity in breast cancer survivors; secondary measures included changes in dietary habits, weight, and QOL. 20 obese or overweight breast cancer survivors who recently completed active breast cancer treatment were recruited into a single-arm, 12-week WCI pilot feasibility study. The intervention was comprised of one in-person wellness coaching visit followed by four telephone calls over 12 weeks and 12 weekly emails containing wellness recommendations. Significant improvements from pre- to postintervention were seen in physical activity level, dietary habits, and in some aspects of QOL. Forty percent of participants achieved the 3% postintervention weight-loss goal, but this was not sustained at 30 weeks.

Relationship of anxiety and depression symptoms with the different domains of physical activity in breast cancer survivors

Background Physical activity (PA) has shown benefits in the mental health of breast cancer (BC) survivors. However, it is unclear if different domains of PA are related to the emotional well-being of this population. The objective of this study was to verify the relationship between different domains of PA [occupational, exercise/sport participation and leisure time/commuting] with symptoms of anxiety and depression in BC survivors.Methods It is a cross-sectional study, composed of 128 women breast cancer survivor, in which the socioeconomic class was evaluated through the questionnaire of the Brazilian Association of Research Companies (ABEP), PA level was evaluated through the Baecke questionnaire, and, symptoms of anxiety and depression were evaluated through the Hospital Anxiety and Depression Scale (HADS).Results It was verified that occupational PA related to anxiety (B = 1.44 [95% CI: 0.11; 2.76]) and leisure time/commuting PA was negatively related to depression (B=-0.99 [95% CI: -1.64;-0.34]), even after adjustment of analysis by age, marital status, and socioeconomic status. There was no correlation between exercise/sport participation with scores of anxiety and depression in BC survivors. Physical activity at leisure time/commuting was negatively related with depression in BC survivors with mastectomy (B=-1.20 [95% CI:-1.92; -0.47).Limitations The difficulty of recruiting the studied population and the absence of subsidy for participation in the study are factors to be considerate.Conclusions Occupational PA may not to be indicated in the management of emotional disorders in BC survivors; however, leisure time/commuting may be recommended to contribute to the mental well-being of this population.

Associations between alcohol consumption and physical activity in breast cancer survivors.

Alcohol use and physical inactivity are associated with increased risk of cancer diagnosis and recurrence. Physical activity (a health protective behavior) is positively associated with alcohol use (a health risk behavior) in the general population but has yet to be examined in breast cancer survivors. This study examined associations between weekly alcohol use and physical activity in 197 post-treatment breast cancer survivors (Mage = 55.04, SDage = 10.92). Participants wore an accelerometer and provided self-reported alcohol intake for five 7-day waves every 3months. Survivors who engaged in more light intensity physical activity had increased odds of consuming alcohol (odds ratio = 1.14, p = .02) but did not differ in the amount of alcohol consumed. When promoting physical activity among this population, it is important to consider the increased likelihood of alcohol consumption.

Using a cultural dance program to increase sustainable physical activity for breast cancer survivors—A pilot study

BackgroundStudies have shown that physical activity can reduce the risk of mortality for female breast cancer patients and improve quality of life, reduce weight, and alter circulating biomarker levels. We conducted a pilot trial to determine the feasibility of increasing physical activity through a cultural dance intervention to achieve similar benefits. MethodsConducted a pilot trial implementing a cultural dance intervention to increase and sustain physical activity for breast cancer survivors, which consisted of a six-month group-based intervention of Hula Dance. Anthropometric measures, fasting blood draws, and self-reported questionnaires to assess physical activity, mood, and quality of life, were completed at baseline, at the end of the 6-month intervention (time point month-6), and at two additional post-intervention time points (month-12 and month-24) to assess sustainability. ResultsA total of 11 women with a median age of 63 years were enrolled in the intervention trial. Eight of the 11 (73%) completed the trial to month-12 and demonstrated an overall significant increase in weekly moderate exercise. There were no significant changes in intra-individual body mass index (BMI). However, there was a sustained post-intervention reduction in waist circumference and significant changes in circulating biomarker levels. For the self-reported measures, there was a significant increase in vigor/activity (p < 0.001; Profile of Mood States-Short Form). ConclusionOur intervention pilot trial demonstrated that a cultural dance program could achieve a sustainable increase in physical activity for breast cancer survivors, with potential to improve quality of life, increase vigor, and decrease levels of circulating cytokines associated with obesity and inflammation.

An Assessment of Physical Activity Data Collected via a Smartphone App and a Smart Band in Breast Cancer Survivors: Observational Study.

BackgroundAlthough distress screening is crucial for cancer survivors, it is not easy for clinicians to recognize distress. Physical activity (PA) data collected by mobile devices such as smart bands and smartphone apps have the potential to be used to screen distress in breast cancer survivors.ObjectiveThe aim of this study was to assess data collection rates of smartphone apps and smart bands in terms of PA data, investigate the correlation between PA data from mobile devices and distress-related questionnaires from smartphone apps, and demonstrate factors associated with data collection with smart bands and smartphone apps in breast cancer survivors.MethodsIn this prospective observational study, patients who underwent surgery for breast cancer at Asan Medical Center, Seoul, Republic of Korea, between June 2017 and March 2018 were enrolled and asked to use both a smartphone app and smart band for 6 months. The overall compliance rates of the daily PA data collection via the smartphone walking apps and wearable smart bands were analyzed in a within-subject manner. The longitudinal daily collection rates were calculated to examine the dropout pattern. We also performed multivariate linear regression analysis to examine factors associated with compliance with daily collection. Finally, we tested the correlation between the count of daily average steps and distress level using Pearson correlation analysis.ResultsA total of 160 female patients who underwent breast cancer surgeries were enrolled. The overall compliance rates for using a smartphone app and smart bands were 88.0% (24,224/27,513) and 52.5% (14,431/27,513), respectively. The longitudinal compliance rate for smartphone apps was 77.8% at day 180, while the longitudinal compliance rate for smart bands rapidly decreased over time, reaching 17.5% at day 180. Subjects who were young, with other comorbidities, or receiving antihormonal therapy or targeted therapy showed significantly higher compliance rates to the smartphone app. However, no factor was associated with the compliance rate to the smart band. In terms of the correlation between the count of daily steps and distress level, step counts collected via smart band showed a significant correlation with distress level.ConclusionsSmartphone apps or smart bands are feasible tools to collect data on the physical activity of breast cancer survivors. PA data from mobile devices are correlated with participants’ distress data, which suggests the potential role of mobile devices in the management of distress in breast cancer survivors.Trial RegistrationClinicalTrials.gov NCT03072966; https://clinicaltrials.gov/ct2/show/NCT03072966