• Development and Validation of...

*Result*: Development and Validation of a Simulation Model-Based Tool to Support Individualized Physical Activity Discussions and Prescriptions for Breast Cancer Survivors.

Title:
Development and Validation of a Simulation Model-Based Tool to Support Individualized Physical Activity Discussions and Prescriptions for Breast Cancer Survivors.
Authors:
Jayasekera JC; Intramural Research Program at the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD., Wilson OWA; Intramural Research Program at the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD., Schechter C; Department of Family and Social Medicine at Albert Einstein College of Medicine, Bronx, NY., Jin JLC; Department of Medicine, Stanford University School of Medicine, Stanford, CA., Wojcik KM; Intramural Research Program at the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD., van Ravesteyn NT; Erasmus MC, University Medical Center Rotterdam, the Netherlands., Wall J; People Designs, Inc., Durham, NC., Schneider J; Intramural Research Program at the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD., D'Addario LL; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA., Roh JM; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA., Sarkar S; Department of Oncology, Georgetown University Medical Center, Washington, DC., Cadmus-Bertram L; University of Wisconsin-Madison, Madison, WI., Pierce JP; Moores Cancer Center, University of California, San Diego, CA., Trentham-Dietz A; Carbone Cancer Center and Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI., Kushi LH; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA., Matthews CE; Division of Cancer Epidemiology and Genetics, Intramural Research Program at the National Cancer Institute, National Institutes of Health, Bethesda, MD.
Source:
JCO clinical cancer informatics [JCO Clin Cancer Inform] 2025 Oct; Vol. 9, pp. e2500151. Date of Electronic Publication: 2025 Oct 17.
Publication Type:
Journal Article; Validation Study
Language:
English
Journal Info:
Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 101708809 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2473-4276 (Electronic) Linking ISSN: 24734276 NLM ISO Abbreviation: JCO Clin Cancer Inform Subsets: MEDLINE
Imprint Name(s):
Original Publication: Alexandria, VA : American Society of Clinical Oncology, [2017]-
MeSH Terms:
Breast Neoplasms*/mortality , Breast Neoplasms*/therapy , Breast Neoplasms*/epidemiology , Cancer Survivors* , Exercise*, Humans ; Female ; Aged ; Middle Aged ; Computer Simulation
References:
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Grant Information:
P30 CA014520 United States CA NCI NIH HHS; U01 CA253911 United States CA NCI NIH HHS; ZIA MD000022 United States ImNIH Intramural NIH HHS
Entry Date(s):
Date Created: 20251017 Date Completed: 20251017 Latest Revision: 20251025
Update Code:
20260130
PubMed Central ID:
PMC12543000
DOI:
10.1200/CCI-25-00151
PMID:
41105911
Database:
MEDLINE

*Further Information*

*Purpose: Clinical guidelines recommend offering individualized physical activity prescriptions to cancer survivors. However, there are limited tools to support individualized physical activity discussions and prescriptions. We developed and validated a simulation model-based tool to estimate individualized survival outcomes for postdiagnosis physical activity among postmenopausal breast cancer survivors.
Methods: We adapted an established simulation modeling approach developed within the Cancer Intervention and Surveillance Modeling Network to estimate breast cancer-specific and all-cause survival associated with postdiagnosis physical activity for 50- to 75-year-old (postmenopausal) women with stage I to III invasive breast cancer. Model estimates were generated for 60,480 subgroups based on age, weight status (BMI), stage, tumor subtype, treatment, aerobic (<30 min/wk [no/minimal], ≥30 to <150 min/wk [insufficient], ≥150 to <300 min/wk [active], ≥300 min/wk [highly active]), and muscle-strengthening (<2 or ≥2 d/wk) activity. The outcomes were 10-year survival and absolute survival benefits for different levels of physical activity by individual characteristics and treatment. Model inputs were derived from trials, cohort studies, registry, and surveillance data. External validation used independent data.
Results: Survival rates and absolute benefits for physical activity varied by age, weight status, stage, tumor subtype, and amount and type of activity. For example, the 10-year breast cancer-specific and all-cause survival for no/minimal activity in a 65- to 69-year-old-woman with stage II, hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer with obesity was 79.2% and 72.2%, respectively. Increasing aerobic activity from no/minimal to insufficient activity with <2 d/wk of muscle-strengthening was associated with absolute increases in 10-year breast cancer-specific and all-cause survival by 2.8 and 3.4 percentage points, respectively. The model closely replicated survival rates in independent data.
Conclusion: Simulation model-based estimates could support clinical tools for guideline-recommended individualized discussions and physical activity prescriptions for breast cancer survivors.*