Key result
Reduced physical performance on the six-minute walk test in patients receiving anthracycline-based chemotherapy was significantly predicted by anemia severity, hypertension level, reduced left ventricular ejection fraction, and number of therapy cycles.
Why the study?
Conventional cardiotoxicity assessment methods based on LVEF have limited prognostic value and may not fully reflect functional decline and quality of life in breast cancer patients undergoing anticancer therapy.
Cohort (n=30)
No
Reduced physical performance in breast cancer patients receiving anthracyclines is multifactorial and strongly predicted by anemia, hypertension, reduced LVEF, and cumulative treatment cycles, highlighting the need for comprehensive rehabilitation rather than solely monitoring resting LVEF.
Supports multifactorial assessment beyond LVEF alone during anthracycline chemotherapy; leaves open whether targeting these factors improves functional outcomes.
BACKGROUND: Advances in oncology have contributed to increased survival among patients. Cardiovascular toxicity remains a significant concern in women with breast cancer undergoing anticancer therapy. Conventional methods for assessing cardiotoxicity, primarily based on left ventricular ejection fraction, have limited prognostic value and may not fully reflect post-treatment functional decline and reduced quality of life. AIM: This study aimed to evaluate the contribution of various physiological factors to reduced physical performance in patients with breast cancer receiving anthracycline-based chemotherapy. METHODS: This cohort study included 30 patients with breast cancer undergoing neoadjuvant anthracycline-based chemotherapy. Comprehensive assessment comprised echocardiography, laboratory tests, psychometric questionnaires, and the six-minute walk test. Statistical analysis included correlation and regression analyses to identify predictors of reduced physical performance. RESULTS: Most patients were overweight or obese and had concomitant anemia and hypertension. Patients with low daily physical activity more frequently exhibited a 10% decrease in left ventricular ejection fraction over the past 3 months and poorer performance on the six-minute walk test. Multiple regression analysis identified anemia severity, hypertension level, reduced left ventricular ejection fraction, and the number of chemotherapy and radiotherapy cycles as significant predictors of decreased physical performance. Psychoemotional disorders and treatment adherence did not have a statistically significant impact. CONCLUSION: Reduced physical performance in patients receiving anthracycline-based chemotherapy for breast cancer is driven by a combination of cardiovascular, pulmonary, and hematologic factors. The study was limited by a small sample size. Future research should focus on the development of personalized rehabilitation programs aimed at minimizing cardiotoxic effects and restoring functional capacity in patients with cancer.
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Blinova et al. (2025) conducted a cohort in Breast cancer (n=30). High/medium daily physical activity vs. Low daily physical activity was evaluated on Distance walked in the six-minute walk test (in meters) (p=<0.05). Reduced physical performance on the six-minute walk test in patients receiving anthracycline-based chemotherapy was significantly predicted by anemia severity, hypertension level, reduced left ventricular ejection fraction, and number of therapy cycles.
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