Exercise, Fitness and Tumor Profiling in Breast Cancer Patients

Inclusion Criteria: Cohort 1: Breast Cancer Patients * Ages 21-80 years * Female * Histologically confirmed ER receptor positive (\>1% staining), HER2 negative (FISH ratio \<1.8), untreated operable breast cancer * Stage I to II disease * Scheduled for surgical resection by any type of mastectomy or lumpectomy at MSK * Tumor size ≥1cm by preoperative imaging or physical examination * Categorization into self-reported exercise history exposure classifications as follows: (1) exercising: ≥120 minutes of vigorous-intensity exercise/wk for the past 12 months, and (2) sedentary (non-exercising): ≤ 30 minutes of moderate-intensity exercise/week for the past months using the Harvard Health Professionals survey.(34) * Ability to read and understand English * Willing and able to comply with requirements of the protocol Cohort 2: High-Risk Patients * Women at high-risk of breast cancer, as defined by one of the following: * Cytologically confirmed atypical hyperplasia * confirmed LCIS * Being a carrier for BRCA1 and/or BRCA2 * Predicted lifetime risk of breast cancer \>20% based on family history * Predicted 10-year risk of breast cancer of ≥2.31% * Predicted 5-year risk of breast cancer ≥1.67% * Aged 21-80 years old * If a female of child-bearing potential, must not be pregnant or planning to become pregnant during the study. * Women \<50 years old of child-bearing potential must have a negative pregnancy test (urine HCG or serum) within 14 days of enrollment. Exclusion Criteria: Cohort 1: * Received any form of neoadjuvant treatment * Presence of any other concurrent, actively treated malignancy * Presence of metastatic disease * If performing a CPET, any of the following contraindications: * Acute myocardial infarction within 3-5 days of any planned study procedures; * Unstable angina * Uncontrolled arrhythmia causing symptoms or hemodynamic compromise * Recurrent syncope * Active endocarditis * Acute myocarditis or pericarditis * Symptomatic severe aortic stenosis * Uncontrolled heart failure * Acute pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures * Thrombosis of lower extremities * Suspected dissecting aneurysm * Uncontrolled asthma * Pulmonary edema * Respiratory failure * Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis). * Mental impairment leading to inability to cooperate * If performing a CPET, room air desaturation at rest ≤ 85% * Any other condition or intercurrent illness that, in the opinion of the investigator, makes the participant a poor candidate for the study. Cohort 2: * Use of any selective estrogen receptor modulator or aromatase inhibitor within 6 months of consent, including, but not limited to: tamoxifen, raloxifene, arzoxifene, acolbifene, anastrozole, exemestane, and letrozole. * Enrollment on an interventional investigational study * Bilateral breast implants * History of any of the following: * Invasive breast cancer * DCIS * Any current invasive cancer diagnosis * Metastatic malignancy of any kind * If performing a CPET, any of the following contraindications: * Acute myocardial infarction within 3-5 days of any planned study procedures; * Unstable angina * Uncontrolled arrhythmia causing symptoms or hemodynamic compromise * Recurrent syncope * Active endocarditis * Acute myocarditis or pericarditis * Symptomatic severe aortic stenosis * Uncontrolled heart failure * Acute pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures * Thrombosis of lower extremities * Suspected dissecting aneurysm * Uncontrolled asthma * Pulmonary edema * Respiratory failure * Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis). * Mental impairment leading to inability to cooperate * If performing a CPET, room air desaturation at rest ≤ 85% * Any other condition or intercurrent illness that, in the opinion of the investigator, makes the participant a poor candidate for the core biopsy or the study.