ArticleBreast cancer research and treatment2026
The association of an exercise and rehabilitation clinical workflow algorithm on sedentary behavior and performance status from time of breast cancer diagnosis and throughout care.
Article in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeExplore if a clinical workflow algorithm that connected Stage I-III newly diagnosed breast cancer (BC) patients to exercise and rehabilitation services from diagnosis throughout care associated with a lower percentage of time spent in sedentary behavior (SB)compared with standard of care (SOC). We also examined the relationship between SB and ECOG performance status scores, a measure of functional status.
methodsThis secondary data analysis from the Comprehensive Oncology Rehabilitation and Exercise (CORE) program was carried out among 51 BC survivors (CORE = 33, SOC = 18) with evaluable wrist-worn accelerometer data. Percentage of time in SB was assessed using wrist-worn specific cut-points (Montoye) and traditional cut-points (Freedson) three times during BC care: preoperative, first postoperative visit, and 24 weeks postoperative. Repeated measures analysis of covariance tests (RM-ANCOVA; adjusted for age, cancer stage, and number of postoperative treatments) with post-hoc comparisons evaluated SB over time within and between groups. Poisson regression evaluated associations between SB and ECOG.
resultsParticipants were mostly white (76.5%), non-Hispanic (90.2%), with mean age 58.8 ± 12.3 years, diagnosed with Stage I BC (86.3%) and had a history of more than two adjuvant treatments (56.9%), with no significant differences between groups (p > 0.05). Proportion of time spent in SB (Montoye cut-points) was 73.95% (95% CI 70.60, 77.30) preoperatively; 77.79% (95% CI 74.23, 81.35) postoperatively; and 75.05% (95% CI 71.88, 78.22) 24 weeks postoperatively, although these time effect results did not reach statistical significance in the adjusted model. A time x group interaction was observed with Freedson cut-points (mean difference: 6.15%, 95% CI 0.42, 11.88). Between preoperative and 24 weeks postoperative timepoints, pairwise comparisons indicated that CORE intervention group participants exhibited a significant increase in percentage of time in SB (mean difference: 6.09%, 95% CI 0.24, 11.93). ECOG scores at each timepoint were not associated with SB (p > 0.05).
conclusionCORE program participation was not associated with reduced SB. Strategies to reduce SB should be incorporated within programs aimed at increasing physical activity engagement.
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