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Open Access Highly Accessed Study protocol

The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors

Kerry S Courneya110*, Jeff K Vallance2, S Nicole Culos-Reed3, Margaret L McNeely4, Gordon J Bell1, John R Mackey5, Yutaka Yasui6, Yan Yuan6, Charles E Matthews7, David CW Lau8, Diane Cook1 and Christine M Friedenreich9

Author affiliations

1 Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada

2 Faculty of Health Disciplines, Athabasca University, Athabasca, Canada

3 Faculty of Kinesiology, University of Calgary, Calgary, Canada

4 Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

5 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

6 School of Public Health, University of Alberta, Edmonton, Canada

7 Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, Maryland

8 Faculty of Medicine, University of Calgary, Calgary, Canada

9 Department of Epidemiology, Alberta Health Services, Calgary, Canada

10 Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, Canada

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Citation and License

BMC Cancer 2012, 12:525  doi:10.1186/1471-2407-12-525

Published: 16 November 2012

Abstract

Background

Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the

    A
lberta
    M
oving
    Be
yond B
    r
east Cancer (AMBER) Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death.

Methods/Design

The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery), 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes.

Discussion

The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1) the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival), treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy), quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness), (2) the determinants of physical activity and health-related fitness including demographic, medical, social cognitive, and environmental variables, (3) the mediators of any observed associations between physical activity, health-related fitness, and health outcomes including biological, functional, and psychosocial, and (4) the moderators of any observed associations including demographic, medical, and biological/disease factors. Taken together, these data will provide a comprehensive inquiry into the outcomes, determinants, mechanisms, and moderators of physical activity and health-related fitness in breast cancer survivors.

Keywords:
Breast cancer; Exercise; Physical activity; Cardiorespiratory fitness; Muscular strength; Lymphedema; Quality of life; Exercise determinants; Recurrence; Survival