Background We examined cardiorespiratory fitness (CRF) levels in early-stage breast cancer patients and determined whether CRF differs as a function of adjuvant therapy regimen. Patients and methods A total of 180 early breast cancer patients representing three treatment groups (surgery only, single-modality adjuvant therapy, and multi-modality adjuvant therapy) in the Cooper Center Longitudinal Study (CCLS) were studied. A non-cancer control group (n=180) matched by sex, age, and date of the CCLS visit were included. All subjects underwent an incremental exercise tolerance test to symptom limitation to assess CRF (i.e., peak METs and time to exhaustion). Results The mean time from breast cancer diagnosis to exercise tolerance testing was 7.4 ± 6.2 years. In adjusted analyses, time to exhaustion and peak METs were incrementally impaired with the addition of surgery, single-modality, and multi-modality adjuvant therapy compared to matched controls (p=0.006 and p=0.028, respectively). CRF was lowest in the multi-modality group compared to all other groups (all p’s <0.05). Conclusions Despite being seven years post diagnosis, asymptomatic early breast cancer survivors have marked reductions in CRF. Patients treated with multi-modal adjuvant therapy have the greatest impairment in CRF.

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