Health Of Breast Cancer Survivors Research Articles

Pilot randomized trial of a volitional help sheet‐based tool to increase leisure time physical activity in breast cancer survivors

To develop and test a volitional help sheet-based tool to improve physical activity in breast cancer survivors compared to a standard self-generated implementation intention intervention. Pilot randomized trial conducted online over 3months. Participants were randomized to an online volitional help sheet (n=50) or implementation intention (n=51) intervention. Measures were taken at baseline, 1 and 3months. The main outcome measure was moderate-strenuous leisure timephysical activity. Secondary outcomes were health-related quality of life and mood. Participants exposed to the volitional help sheet and implementation intention interventions showed similar effects after 1month, with both groups reporting a significant increase in moderate-strenuous physical activity. After 3months, the initial increase in physical activity was maintained by the volitional help sheet group, but not the implementation intention group. Improvements were also found for negative affect and emotional quality of life. While both interventions show promise in promoting physical activity in breast cancer survivors, the volitional help sheet may be more effective for facilitating lasting change and emotional well-being. Findings suggest that the volitional help sheet may have potential to offer a cost-effective contribution to consumer-led tertiary preventive health. Future research should test these initial findings in a definitive trial. Statement of contribution What is already known on this subject? Physical activity is important for optimizing health in breast cancer survivors. Despite this, physical activity in this cohort remains low. Theory-based strategies are needed to help breast cancer survivors independently manage and maintain regular physical activity over the long term. What does this study add? Online planning interventions can improve physical activity in breast cancer survivors. Volitional help sheets, but not implementation intentions, show sustained effects for 3months. The intervention shows promise as a potential low-cost addition to long-term survivorship care plans.

The Augusta, Georgia Breast Cancer Survivor Study

Several studies have provided important information about health conditions and other challenges faced by women diagnosed with breast cancer and how they can improve their quality of life and reduce their risk of cancer recurrence. Although African American and Hispanic breast cancer patients have a poorer survival than their white counterparts, few studies have compared the experiences of African American, Hispanic, and non-Hispanic white breast cancer survivors. To facilitate collaborative studies on breast cancer survivorship in a multicultural population, including future intervention research on nutrition, and physical activity, and clinical substudies. This cohort study consists of a postal survey of up to 1,000 women with a history of a breast cancer diagnosis who reside in Augusta-Richmond County, Georgia, USA, and a repeat survey in 4 to 5 years to obtain longitudinal data. The follow-up survey in 4 to 5 years will allow for longitudinal changes in health to be assessed. The survey will provide a comprehensive picture of the health of breast cancer survivors, across the lifespan, in a large Southern city. A broad range of health issues will be addressed including physical activity, diet, nutrition, personal and family history of cancer, quality-of-life, psychosocial concerns, and beliefs about cancer recurrence risk reduction through lifestyle changes. Through its longitudinal design, the study will also provide important information about changes in physical and mental health as breast cancer survivors advance in age.

Breast Cancer Survivors Maintain Exercise after Breast Cancer Survivors Maintain Exercise after Team Triathlon Training

Breast Cancer Survivors (BCS) often do not exercise at recommended levels. Estimates are that only 21% exercise at recommended levels 10 years after treatment. Interventional exercise programs examining exercise maintenance have found 49% to 58% maintain exercise at 6 months, and less then 50% of BCS can be expected to maintain exercise levels at 1 year or longer. Our previous studies have shown improvement in physical and psychosocial function with a 14-week training program. The 14- week triathlon training was comprised of two supervised group sessions and three home-based sessions per week. The training program culminated with participation in a sprint distance triathlon (0.25-0.5 mi swim, 12-15 mi bike, 3.1 mi run). PURPOSE: To determine if BCS who participate in a triathlon training program maintain high exercise levels after training. METHODS: Female BCS (n=156) were asked to complete a mailed survey about their leisure time activity 1-6 years after completing a triathlon training program. A Leisure Score Index (LSI) was derived from the Godin Leisure-Time Activity Questionnaire in the survey. Those completing the survey who reported the highest and lowest LSI scores were invited to participate in testing which included weight, BMI, body fat and circumference measurements as well as a 6-minute walk test and the FACIT-fatigue scale. RESULTS: Eighty (75%) reported LSI of 24 or greater. A subset of BCS with high (H) scores (n=6) and low (L) scores (n=5) were tested. No significant group differences (p>.05) were noted in age (H=62.3(5.1), L=56.6(5.7)yrs), time since training (H=3.2(1.7), L=3.2(1.3) yrs), and 6MWT (H=593.2(60.6), L=553.4(29.6) min p>0.1). Group differences were found in hip circumferences (H=96.2(6.9) L=116(11.5) cm, p<.01), waist circumferences (H=79.8(11.2) L=97.5(9.1) cm, p<.05), weight (H= 61.0(9.9) L=86.2(12.9)kg, p<.01), BMI (H=23.2(3.2), L=39.2(13.7) p<.05), body fat % (H=36.7(2.4) L=46.8(5.1), p<.01) and fatigue (H=49.3(2.1), L=34.8 (14.8) p<.05). Data are mean (sd). CONCLUSIONS: Structured training for BCS can lead to higher levels of activity maintenance at 1-6 years after training. Thus, triathlon training could lead to continued exercise, less fatigue, and better health in breast cancer survivors.

A meta-analysis of the efficacy of cognitive behavior therapy on quality of life and psychological health of breast cancer survivors and patients.

The aim of this study was to examine the effect of cognitive behavior therapy (CBT) on quality of life (QOL) and psychological health of breast cancer survivors and patients. A total of 1289 references were examined from an overall literature search in PubMed, Embase, CINAHL, and the Cochrane Database of Systematic Reviews. Randomized controlled trials assessing the efficacy of CBT compared with a range of comparators in cancer survivors. We assessed the effect of CBT by using the standardized mean difference as effect size. Among 1289 abstracts and 292 full-text articles reviewed, 10 studies were included. At the posttreatment period, the pooled effect size for CBT on QOL was 0.57 (95% CI, 0.44 to 0.69; P<.001), on depression was -1.11 (95% CI, -1.28 to -0.94; P<.001), on stress was -0.40 (95% CI, -0.53 to -0.26; P<.001), on anxiety was -1.10 (95% CI, -1.27 to -0.93; P<.001), and on hyperarousal cluster of symptoms was -0.18 (95% CI, -0.30 to -0.05; P<.001). The QOL was considered statistically medium effect sizes. The depression and anxiety were considered statistically large effect sizes. Cognitive behavior therapy is an effective therapy for psychological symptoms of cancer survivors and patients, with meaningfully clinical effect sizes. These findings suggested that CBT should be used as the intervention for breast cancer survivors and patients when possible.

Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review

BackgroundBreast cancer related lymphedema (BCRL) is a prevalent complication secondary to cancer treatments which significantly impacts the physical and psychological health of breast cancer survivors. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy, for BCRL. This systematic review evaluated the effectiveness of LLLT (PBM) in the management of BCRL.MethodsClinical trials were searched in PubMed, AMED, Web of Science, and China National Knowledge Infrastructure up to November 2016. Two reviewers independently assessed the methodological quality and adequacy of LLLT (PBM) in these clinical trials. Primary outcome measures were limb circumference/volume, and secondary outcomes included pain intensity and range of motion. Because data were clinically heterogeneous, best evidence synthesis was performed.ResultsEleven clinical trials were identified, of which seven randomized controlled trials (RCTs) were chosen for analysis. Overall, the methodological quality of included RCTs was high, whereas the reporting of treatment parameters was poor. Results indicated that there is strong evidence (three high quality trials) showing LLLT (PBM) was more effective than sham treatment for limb circumference/volume reduction at a short-term follow-up. There is moderate evidence (one high quality trial) indicating that LLLT (PBM) was more effective than sham laser for short-term pain relief, and limited evidence (one low quality trial) that LLLT (PBM) was more effective than no treatment for decreasing limb swelling at short-term follow-up.ConclusionsBased upon the current systematic review, LLLT (PBM) may be considered an effective treatment approach for women with BCRL. Due to the limited numbers of published trials available, there is a clear need for well-designed high-quality trials in this area. The optimal treatment parameters for clinical application have yet to be elucidated.

Smartphone-Enabled Health Coaching Intervention (iMOVE) to Promote Long-Term Maintenance of Physical Activity in Breast Cancer Survivors: Protocol for a Feasibility Pilot Randomized Controlled Trial.

BackgroundAlthough physical activity has been shown to contribute to long-term disease control and health in breast cancer survivors, a majority of breast cancer survivors do not meet physical activity guidelines. Past research has focused on promoting physical activity components for short-term breast cancer survivor benefits, but insufficient attention has been devoted to long-term outcomes and sustained exercise adherence. We are assessing a health coach intervention (iMOVE) that uses mobile technology to increase and sustain physical activity maintenance in initially inactive breast cancer survivors.ObjectiveThis pilot randomized controlled trial (RCT) is an initial step in evaluating the iMOVE intervention and will inform development of a full-scale pragmatic RCT.MethodsWe will enroll 107 physically inactive breast cancer survivors and randomly assign them to intervention or control groups at the University Health Network, a tertiary cancer care center in Toronto, Canada. Participants will be women (age 18 to 74 years) stratified by age (55 years and older/younger than 55 years) and adjuvant hormone therapy (AHT) exposure (AHT vs no AHT) following breast cancer treatment with no metastases or recurrence who report less than 60 minutes of preplanned physical activity per week. Both intervention and control groups receive the 12-week physical activity program with weekly group sessions and an individualized, progressive, home-based exercise program. The intervention group will additionally receive (1) 10 telephone-based health coaching sessions, (2) smartphone with data plan, if needed, (3) supportive health tracking software (Connected Wellness, NexJ Health Inc), and (4) a wearable step-counting device linked to a smartphone program.ResultsWe will be assessing recruitment rates; acceptability reflected in selective, semistructured interviews; and enrollment, retention, and adherence quantitative intervention markers as pilot outcome measures. The primary clinical outcome will be directly measured peak oxygen consumption. Secondary clinical outcomes include health-related quality of life and anthropometric measures. All outcome measures are administered at baseline, after exercise program (month 3), and 6 months after program (month 9).ConclusionsThis pilot RCT will inform full-scale RCT planning. We will assess pilot procedures and interventions and collect preliminary effect estimates.Trial RegistrationClinicalTrials.gov NCT02620735; https://clinicaltrials.gov/ct2/show/NCT02620735 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02620735)

Abstract 3271: Evaluation of bone health in breast cancer survivors compared to cancer-free women: A prospective study within a young familial risk cohort

Abstract Background: Bone loss has been consistently reported among long-term older breast cancer (BC) survivors. However, it remains unclear how early and to what degree BC survivors experience bone loss compared to their cancer-free peers and to what extent this can be attributed to age and premature menopause. Methods: We studied 796 women (210 BC survivors, 586 cancer-free) with familial risk of breast and/or ovarian cancer in the Breast and Ovarian Surveillance Service (BOSS) cohort at Johns Hopkins Hospital. Survivors were diagnosed with stage I-III BC &amp;lt;5 years prior to baseline (mean time from diagnosis to enrollment=1.4 years; mean age at diagnosis=47 years). Osteopenia and osteoporosis were ascertained based on self-reported physician diagnosis in baseline and follow-up questionnaires. Prevalent cases of osteopenia or osteoporosis were excluded. Multivariable (MV)-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of osteopenia and osteoporosis incidence among BC survivors compared to cancer-free women. MV models were adjusted for age, race, menopause status, body mass index, physical activity, smoking, hormone replacement therapy and early oophorectomy. Results: BC survivors were slightly older (mean age 48 vs. 45 years), more likely to be post-menopausal (51% vs. 29%) and had higher current vitamin D use (21% vs. 8%) compared to cancer-free women. During a mean follow-up time of 6.2 years, 77% of BC survivors and 60% of cancer-free women reported having ≥1 bone density exam and 115 incident osteopenia and/or osteoporosis cases were identified (75% osteopenia only). In MV-adjusted models, BC survivors had 66% higher risk of being diagnosed with osteopenia and/or osteoporosis compared to cancer-free women (HR=1.66, 95% CI=1.11-2.47). BC survivors with no current vitamin D or calcium use had 76% and 93% higher osteopenia and/or osteoporosis risk compared to cancer-free women, respectively (MV HR=1.76, 95% CI=1.14-2.72; MV HR=1.93, 95% CI=1.15-3.24). BC survivors ever treated with chemotherapy or hormone therapy had higher osteopenia and/or osteoporosis risk compared to cancer-free women (MV HR=2.00, 95% CI=1.14-3.50; MV HR=1.79, 95% CI=1.14-2.82, respectively). Analyses restricted to women with no change in menopause status during follow-up were only slightly attenuated (MV HR=1.58, 95% CI=0.96-2.59). Conclusion: Our results demonstrate that bone loss is significantly greater than and occurs early in young BC survivors compared to cancer-free women even after taking into consideration increasing age and premature menopause. Our findings also provide support for a baseline evaluation of bone density at diagnosis with subsequent monitoring in young BC survivors with familial risk. Further analyses are ongoing to evaluate the effect of specific BC treatments on bone health in this cohort. Citation Format: Cody A. Ramin, Betty J. May, Richard B. Roden, Dana Petry, Deborah K. Armstrong, Kala Visvanathan. Evaluation of bone health in breast cancer survivors compared to cancer-free women: A prospective study within a young familial risk cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3271. doi:10.1158/1538-7445.AM2017-3271

The Effects of Dietary Nutrition Education on Weight and Health Biomarkers in Breast Cancer Survivors.

Weight gain after breast cancer diagnosis portends a poorer prognosis, and the majority of sufferers appear to gain weight. Metabolic syndrome is a common co-condition with breast cancer. The Mediterranean diet has been used to reduce excess weight, metabolic syndrome, and to improve the inflammatory profile, and therefore may offer the breast cancer survivor specific benefits over and above the currently recommended nutrition guidelines to eat a low fat, healthy diet. The aim of this randomised controlled trial was to investigate whether a Mediterranean (MD) or low-fat diet (LF) reduce weight and general health in survivors of stage 1–3 breast cancer through a six-month, six-session education package to support dietary change. A control dietary arm received no intervention. Outcome measures for weight, body mass index (BMI), waist circumference, blood lipids, blood glucose, dietary adherence, 3-day food diary, and PREDIMED questionnaire and quality of life were assessed. Both dietary intervention arms, on average, lost weight over the course of the intervention, with significant (p < 0.05) decreases seen in BMI and waist circumference measurements. The control arm gained weight and significantly (p < 0.05) increased BMI and waist circumference measurements overall (1.10 ± 3.03 kg, 0.40 ± 1.65 kg/m2, and 1.94 ± 2.94 cm respectively). Positive trends in blood biomarkers were observed for the intervention arms. Dietary adherence was sufficient. Nutritional education and group support appears to exert beneficial effects on health in breast cancer survivors, of lesser importance is the type of diet that forms the basis of the education.

Psychophysical health status of breast cancer survivors and effects of 12 weeks of aerobic training

The aim of this study was to analyse the health status of breast cancer survivors and the effects of 12 weeks of aerobic training. Twenty-three breast cancer survivors (51.71 ± 3.17 years) and 23 healthy women (50.73 ± 2.97 years) were investigated for body composition, daily physical activity, quality of life, salivary cortisol, and DHEA-S. Breast cancer survivors were then aerobically trained for 12 weeks. Breast cancer survivors have a worse psychophysical health than healthy women. Aerobic training increased salivary DHEA-S, aerobic fitness, self-reported health, and nocturnal sleeping time and reduced salivary cortisol in breast cancer survivors. Salivary cortisol variation correlated with change of sleeping time and self-reported health. Salivary DHEA-S correlated with change of self-reported physical pain and general health as well. Breast cancer survivors can live in a situation of continuous distress, requiring a multidisciplinary approach. Twelve weeks of aerobic training improve the psychophysical health of breast cancer survivors.

Qualitative Exploration of Sexual Health Among Diverse Breast Cancer Survivors.

Although the physical and emotional impact of surgical removal of partial or complete removal of the breast as well as effects of breast cancer treatment on the individual have been well documented, little research is available on sexuality and sexual health of breast cancer survivors in a relationship context. Sexual health concerns of breast cancer survivors remain an unmet need for many. The present study consisted of qualitative interviews with 135 racially diverse, female breast cancer survivors who completed treatment to better understand their perspectives on sexual health and management of sexual problems in their potential and existing relationships after breast cancer. Key thematic findings include that breast cancer survivors have to (1) adapt to the physical and emotional traumas of breast cancer surgery and treatment, (2) navigate complicated sexual communications with potential and existing partners, and (3) negotiate intimacy and closeness without sexual intercourse with existing partners. This study demonstrates the need for healthcare providers to discuss sexual health after breast cancer with all of their patients as it is a concern that faces single and partnered breast cancer survivors months and years after treatment.

Resilience effect on health of breast cancer survivors: A cross-sectional, correlational study

Resilience effect on health of breast cancer survivors: A cross-sectional, correlational study

Acupuncture to improve circadian health in breast cancer survivors (BCS): An RCT.

10066Background: Acupuncture is a popular complementary modality frequently used by cancer patients and survivors for management of side effects associated with cancer treatments. Circadian rhythm ...

A Community-Based Exercise Rehabilitation Programme Improves Physical And Psychological Health In Breast Cancer Survivors.

A Community-Based Exercise Rehabilitation Programme Improves Physical And Psychological Health In Breast Cancer Survivors.

Issues in Breast Cancer Survivorship: Optimal Care, Bone Health, and Lifestyle Modifications.

There are an estimated 3.1 million survivors of breast cancer in the United States. The predominant reasons for this substantially large population are that breast cancer is the most common noncutaneous malignancy among women and that 5-year survival rates after breast cancer treatment are approximately 90%. These patients have many medical considerations, including the need to monitor for disease recurrence and to manage complications of their previous cancer treatments. Most patients remain at risk indefinitely for local and systemic recurrences of their breast cancers and have an increased risk of developing contralateral new primary breast cancers. Therefore, optimizing care for this patient population is critical to the overall health care landscape in the United States. Here, we summarize survivorship care delivery and its challenges, the optimization of bone health in breast cancer survivors, and opportunities for risk reduction through lifestyle modifications.

Exploring the Feasibility of a Broad-Reach Physical Activity Behavior Change Intervention for Women Receiving Chemotherapy for Breast Cancer: A Randomized Trial.

Facilitating healthy levels of physical activity (PA) during chemotherapy is important for the psychosocial and physical health of breast cancer survivors. The primary objective of this feasibility study was to examine the effects of a broad-reach PA behavior change intervention among women with breast cancer receiving adjuvant chemotherapy. Breast cancer patients receiving adjuvant chemotherapy (N = 95) were randomly assigned to receive a PA resource kit consisting of tailored print materials and a step pedometer (intervention) or a standard public health PA recommendation (standard recommendation). The primary outcome was daily pedometer steps. Secondary outcomes were self-reported light, moderate, and vigorous intensity PA, total moderate-to-vigorous PA, and sedentary time. Assessments were conducted before and after adjuvant chemotherapy. Attrition was 19% (17 of 95). Intervention patients wore their step pedometer for 85 days (range, 35-144 days; SD = 26.4) for a 95% adherence rate. Analyses of covariance suggested that the intervention was not statistically superior to standard recommendation for daily average pedometer steps (-771; 95% CI = -2024 to 482; P = 0.22), total MVPA minutes (-4; 95% CI = -62 to 570; P = 0.90), or sedentary time (+160; 95% CI = -186 to 506; P = 0.42). This broach-reach and low intensive intervention was not more effective for promoting PA in breast cancer patients receiving chemotherapy than providing the standard public health guidelines for PA. Achieving physical activity behavior change during adjuvant breast cancer chemotherapy may require some level of supervised physical activity or more intensive (e.g., face-to-face, supervised) interventions.

Issues in Breast Cancer Survivorship: Optimal Care, Bone Health, and Lifestyle Modifications

There are an estimated 3.1 million survivors of breast cancer in the United States. The predominant reasons for this substantially large population are that breast cancer is the most common noncutaneous malignancy among women and that 5-year survival rates after breast cancer treatment are approximately 90%. These patients have many medical considerations, including the need to monitor for disease recurrence and to manage complications of their previous cancer treatments. Most patients remain at risk indefinitely for local and systemic recurrences of their breast cancers and have an increased risk of developing contralateral new primary breast cancers. Therefore, optimizing care for this patient population is critical to the overall health care landscape in the United States. Here, we summarize survivorship care delivery and its challenges, the optimization of bone health in breast cancer survivors, and opportunities for risk reduction through lifestyle modifications.

How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors?

Physical activity (PA) and sedentary behavior may influence the physical and mental health of breast cancer survivors; however, few studies have objectively measured these behaviors in this population. We used accelerometers to measure the PA and sedentary time levels of breast cancer survivors and examined the demographic, behavioral, and medical correlates of these behaviors using two complementary approaches. A total of 259 breast cancer survivors wore an accelerometer for 7 days during waking hours and completed a questionnaire. We used linear regression and classification trees to investigate correlates of PA and sedentary time. The breast cancer survivors in this study (mean age = 61 years, mean time since diagnosis = 3 years) were sedentary for a daily average of 8.2 h, in light-intensity PA for 5.8 h and in moderate-to-vigorous intensity PA (MVPA) for 32 min, with 16 % meeting PA guidelines. Participants with high comorbidity were the least likely to be meeting guidelines (0 %), while a subgroup of participants with no/low comorbidity, a university degree, and higher levels of pre-diagnosis MVPA were the most likely to be meeting guidelines (47 %). Older participants (70+ years) were the most likely to have sedentary time levels at least twice as high as activity levels, while participants who were younger than 70 years and not in the lowest category of pre-diagnosis MVPA were the least likely. Interventions to facilitate physical activity and reduce sedentary time among breast cancer survivors should consider comorbidity status and previous PA experience.

Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey.

The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health. Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2. In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51-0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47-0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44-0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32-4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32-18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption. This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health.

Higher cardiorespiratory fitness levels are associated with greater hippocampal volume in breast cancer survivors.

As breast cancer treatment is associated with declines in brain and cognitive health, it is important to identify strategies to enhance the cognitive vitality of cancer survivors. In particular, the hippocampus is known to play an important role in brain and memory declines following cancer treatment. The hippocampus is also known for its plasticity and positive association with cardiorespiratory fitness (CRF). The present study explores whether CRF may hold promise for lessening declines in brain and cognitive health of a sample of breast cancer survivors within 3 years of completion of primary cancer treatment. We explored the role of cardiovascular fitness in hippocampal structure in breast cancer survivors and non-cancer female controls, as well as performed a median split to compare differences in hippocampal volume in relatively higher fit and lower fit cancer survivors and non-cancer controls. Indeed, CRF and total hippocampal volume were positively correlated in the cancer survivors. In particular, higher fit breast cancer survivors had comparable hippocampal volumes to non-cancer control participants (Cohen’s d = 0.13; p > 0.3), whereas lower fit breast cancer survivors showed significantly smaller hippocampal volumes compared to both lower fit and higher fit control participants (Cohen’s d = 0.87, p < 0.05). These results are the first to identify that CRF may protect the brain health of breast cancer survivors within 3 years of treatment. The present study uniquely contributes to the field of cancer and cognition and emphasizes the importance of investigating how individual differences in CRF play a role in brain changes of breast cancer survivors.

Linking Physical Self‐Worth to Posttraumatic Growth in a Sample of Physically Active Breast Cancer Survivors

Using a sample of physically active breast cancer survivors (N = 470), the associations between physical self‐worth, enduring stressors, and posttraumatic growth were examined based on thePositivePsychologicalGrowthModel. Structural equation modeling indicated that physical self‐worth accounted for a significant proportion of the variance in enduring stressors, and physical self‐worth and enduring stressors together accounted for significant variance in each of the dimensions of posttraumatic growth. These findings support the positive psychological growth model. Health care professionals and educators may benefit from considering the role of physical self and enduring stressors in the psychosocial health of breast cancer survivors.