BackgroundModerate physical activity is associated with an improved prognosis and psychosocial outcome in breast cancer patients. Although exercise and physical activity are associated with multiple physiological and psychological effects, many of the underlying mechanisms remain obscure. The BEGYN study (Influence of physical activity in breast cancer patients on physiological and psychological parameters and on biomarkers) aims at identifying potential associations between the extent of physical activity, fitness, body composition, immunological biomarkers, psycho-emotional parameters, and the course of treatment during the first year after diagnosis of breast cancer.MethodsThe prospective observational BEGYN study will include 110 non-metastatic breast cancer patients. The patients will be assessed during a base line visit prior to the initiation of the antineoplastic therapy and after 3, 6, 9 and 12 months. The physical activity will be measured using a fitness tracker and a self-assessment diary during the entire study. Each visit will include the assessment of (i) cardiorespiratory fitness measured by spiroergometry, (ii) body composition, (iii) psycho-emotional parameters (quality of life, mental health, fatigue, depression, distress, anxiety, well-being), and (iv) extensive blood tests including routine laboratory, vitamin D, selenium and immunologically relevant biomarkers (e.g., leukocyte subpopulations and cytokine profiles).DiscussionWhereas most studies investigating the influence of physical activity in breast cancer patients focus on specific activities for three months or less, the BEGYN study will quantify the daily physical activity and cardiorespiratory fitness of breast cancer patients based on objective measurements in the context of the oncological therapy for 12 months after diagnosis. The study will reveal potential associations between exercise, immune status and physical as well as psycho-emotional outcome and the clinical course of the disease. Moreover, complementary therapies such as Vit D and Selenium supplementation and parameters investigating the motivation of the patients are part of the study. Due to this holistic approach, the BEGYN study will guide towards confirmatory studies on the role of physical activity in breast cancer patients to develop individualized counselling regarding the recommended type and extent of exercise.Trial RegistrationThis study has been registered at the German Clinical Trials Register DRKS00024829.

(1) Background: Vitamin D plays an important role in many types of cancer. It was the aim of this study to analyze serum 25-hydroxyvitamin D (25(OH)D) levels in newly diagnosed breast cancer patients, and the association with prognostic and lifestyle factors. (2) Methods: 110 non-metastatic breast cancer patients were included in the prospective observational “BEGYN” study at Saarland University Medical Center between September 2019 and January 2021. At the initiation visit, serum 25(OH)D levels were measured. Clinicopathological data on prognosis, nutrition, and lifestyle were extracted from data files and obtained using a questionnaire. (3) Results: Median serum 25(OH)D in breast cancer patients was 24 ng/mL (range 5–65 ng/mL), with 64.8% of patients being vitamin D deficient. 25(OH)D was higher among patients that reported the use of vitamin D supplements (43 ng/mL versus 22 ng/mL; p < 0.001), and in summer compared to other seasons (p = 0.03). Patients with moderate vitamin D deficiency were less likely to have triple negative breast cancer (p = 0.047). (4) Conclusions: Routinely measured vitamin D deficiency is common in breast cancer patients and needs to be detected and treated. However, our results do not support the hypothesis that vitamin D deficiency may be a main prognostic factor for breast cancer.

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Purpose:In recent years, controversial discussions increased whether vitamin D and selenium have an influence on cancer. In the present study, we examined serum vitamin D and selenium levels in breast cancer patients and potential influencing factors. Methods:110 non-metastatic breast cancer patients were included in the prospective observational “BEGYN” study at Saarland University Medical Center between September 2019 and January 2021. Clinicopathological characteristics were documented. At the baseline visit prior to therapy initiation serum vitamin D and selenium levels were measured and patients received a questionnaire on sun exposure, nutrition, and supplement use.Results:Median vitamin D value was 24 µg/l, and median selenium level was 81 µg/l. Vitamin D levels were higher among the 17 patients that reported the use of vitamin D substitution (43 µg/l versus 22 µg/l; p<0.001). In the univariate analysis, vitamin D levels were higher in summer compared to spring (p=0.004), autumn (p=0.028) and winter (p<0.001). Patients with triple negative carcinomas had a higher vitamin D level (+8,9 µg/l compared to other sub entities, p=0.035). The consumption of cream, gouda, and butter was associated with slightly lower vitamin D levels (regression coefficient: -0.36; p=0.004). Vitamin D and selenium levels are comparable to the healthy German population.Conclusion:Almost 2/3 of all breast cancer patients suffer from vitamin D deficiency at diagnosis, whereas selenium levels were in normal range in 96.2 % of the patients. Vitamin D should be measured routinely, to prevent side effects of vitamin D deficiency.