Sarah Blair, MD, Professor and Vice Chair of the Department of Surgery at UC San Diego Health in California, offered her thoughts on the findings from these two studies. She first pointed to the growing body of data showing how nutrition and exercise programs can improve aerobic fitness, quality of life, and range of motion after axillary staging and how they may reduce postmastectomy pain, anxiety, and stress in persons with breast cancer.

“It is important for surgeons to be aware of this literature,” she said. “Two studies presented at the 2023 American Society of Breast Surgeons Annual Meeting highlight important areas of breast cancer treatment that may be underutilized by health-care professionals, but patients can get real benefit.”

Sarah Blair, MD

Pre- and Postoperative Approaches

The study by Wright et al evaluated individualized prehabilitation programs for patients undergoing neoadjuvant chemotherapy. This approach could be particularly important for patients with triple-negative or HER2-positive tumors who may be undergoing more aggressive treatment prior to surgery (which has been shown to improve overall survival). “It is critical that to reduce postoperative complications, patients are in the best possible condition when they get to surgery,” Dr. Blair said.

Patients in Dr. Wright’s study participated in a program that combined exercise with dietary and stress management counseling during neoadjuvant treatment. Positive results in terms of exercise tolerance and quality of life were achieved vs the control group.

The study by Wonders et al focused on the effect of exercise on postoperative quality of life and showed that improvements here can result in fewer visits to the emergency department, hospital, and physicians’ office. “Hopefully, these data can show hospitals that supervised exercise programs are cost-effective and need to be supported,” she said.

“Breast cancer survival is improving for more aggressive disease, but we are giving patients treatments with potentially more side effects. These types of programs can help support patients and give them the best overall outcomes,” Dr. Blair commented. 

DISCLOSURE: Dr. Blair reported no conflicts of interest.