24-week home-based walking program in the early adjuvant setting in breast cancer patients who receive aromatase inhibitor endocrine therapy: lessons learned from the SAKK 95/17 WISE prospective, randomized, multicenter trial.

BACKGROUND

Aromatase inhibitor (AI) induced arthralgia/myalgia (AIA) is a frequent side-effect of adjuvant breast cancer (BC) endocrine therapy. We investigated the effect of a user-friendly activity tracker to accompany a 24-week walking program, from the start of adjuvant AI-therapy, on patient AIA symptom burden and medication adherence.

METHODS

320 early-stage BC patients were included and randomly allocated to the intervention (arm A, n = 158) or control arm (arm B, n = 162). The intervention in arm A was aimed at briskly walking outdoors for 30 min continuously with 100 steps/minute for 5 days a week, versus an unspecified recommendation of physical activity (PA) in arm B. The patients wore an activity tracker with a customized display.

RESULTS

The intervention compliance in arm A was high, 94% of patients completed the 24-week intervention phase and 68% reached the recommended intervention PA goal. Median daily number of steps was higher in arm A (8542 vs. 7742; p = 0.015). At the end of the intervention phase, activity levels were higher in the intervention group (79.1% vs. 72.8%). These higher values remained unchanged in the follow-up phase at 12 months (79.1% vs. 69.8%) and at 24 months (69.6% vs. 61.1%). Neither the high incidence of AIA during the intervention phase (A:58.2% vs. B:56.2%) nor the reported pain levels differed between the trial arms.

CONCLUSION

BC patients are highly motivated to pursue new approaches for health promotion in addition to oncological therapies. Activity trackers with training instructional guidance are useful for maintaining training levels achieved over a longer period of time.