Fitness during Breast Cancer Treatment and Recovery in an Athlete: A Case Study.

Purpose This is a case study of an aerobically trained, multisport, female athlete (age = 39) diagnosed with stage IIIc human epidermal growth factor receptor 2 positive breast cancer. The focus of the study is on measures of cardiorespiratory fitness (VO2peak) through the course of cancer therapy. Methods A symptom-limited cardiopulmonary exercise tolerance test was performed to determine VO2peak. The tests were performed at five different time points: 1) at diagnosis of breast cancer and before initiating chemotherapy, 2) after completion of chemotherapy (5 months postdiagnosis), 3) 2.5 months after bilateral mastectomy surgery (9 months postdiagnosis), 4) immediately after radiation therapy (11 months postdiagnosis), and 5) recovery (32 months postdiagnosis). Results At diagnosis and before initiating chemotherapy, VO2peak was 50.1 mL O(2)min(-1)kg(-1). The most precipitous decline in fitness, approximately 14%, was observed from initial diagnosis through the completion of chemotherapy. The subject regained 9% of her fitness after chemotherapy, despite an intervening mastectomy surgery. Radiation therapy was associated with an approximately 4% decline in fitness from her postmastectomy surgery value. Ultimately, 32 months after diagnosis and 22 months after the completion of radiation therapy, the subject was able to regain pretreatment fitness levels. Conclusion The results of the case study describe the effects of undergoing extensive breast cancer therapy on measures of VO2peak for a highly aerobically trained, multisport athlete. In this case, exercise training reversed the decrement in measured VO2peak that occurred during cancer therapy.