The goal of this clinical trial is to learn whether a 12-week dance-based exercise program can reduce cancer-related fatigue in women with newly diagnosed breast cancer who are undergoing treatment before surgery. The main questions it aims to answer are: Does participating in the dance-based exercise program reduce cancer-related fatigue? Does the program improve quality of life and physical functioning? Researchers will compare women who participate in the dance-based exercise program in addition to their standard cancer care with women who receive standard cancer care alone. Participants in the dance group will take part in supervised 60-minute dance sessions three times per week for 12 weeks. All participants will complete questionnaires and undergo assessments of physical fitness and body composition. Blood and stool samples will also be collected to study changes in the gut microbiome and selected biological markers. Participants will be followed for up to one year after surgery.
Cancer-related fatigue is one of the most prevalent and burdensome symptoms experienced by patients with breast cancer during systemic anticancer treatment. Unlike ordinary tiredness, cancer-related fatigue may persist despite rest and can negatively affect physical functioning, psychological well-being, daily activities, and quality of life. Exercise has been recognized as an important supportive strategy for the management of cancer-related fatigue; however, adherence to conventional exercise programs during intensive cancer treatment may be challenging. Dance-based exercise represents a multimodal form of physical activity combining aerobic exercise, coordination, balance, rhythmic movement, and social and cognitive engagement. Its enjoyable and adaptable nature may provide an alternative approach to maintaining physical activity during cancer treatment. Nevertheless, evidence regarding the effects of structured dance-based exercise during neoadjuvant treatment for breast cancer remains limited. This randomized controlled study will investigate the effects of a structured dance-based exercise intervention in women with breast cancer undergoing neoadjuvant treatment. The study is designed to determine whether incorporating supervised dance-based exercise into the period of neoadjuvant treatment can reduce cancer-related fatigue and support physical and psychosocial functioning compared with standard oncological care alone. The intervention is structured as a progressive, supervised dance-based exercise program delivered during neoadjuvant treatment. The program combines dance-based aerobic activity with movements targeting coordination, mobility, balance, and muscular function. Exercise intensity and complexity will be individually adapted according to participants' physical condition, exercise tolerance, and treatment-related symptoms. This approach is intended to maintain an appropriate exercise stimulus while allowing flexibility in response to changes in health status during oncological treatment. In addition to evaluating the clinical and functional effects of the intervention, the study includes an exploratory mechanistic component. Cancer treatment and physical activity may influence systemic metabolism, inflammatory processes, and the intestinal microbial ecosystem. The study will therefore investigate changes in the gut microbiome and selected circulating biological markers and explore their relationships with changes in fatigue, physical fitness, body composition, physical activity, and other clinical and functional characteristics. The gut microbiome component will characterize microbial composition and diversity using stool samples collected during the study. Blood-based analyses will complement the microbiome assessment by examining selected biological pathways potentially involved in the response to exercise and cancer treatment. Integrating these biological data with functional and patient-reported data may provide insight into mechanisms through which exercise influences health and recovery during neoadjuvant breast cancer treatment. The longitudinal design will also allow the investigators to examine whether changes observed during the intervention period are maintained during recovery following surgery. By combining a randomized exercise intervention with clinical, functional, behavioral, and biological assessments, the study aims to provide a comprehensive evaluation of dance-based exercise as a supportive strategy during neoadjuvant treatment for breast cancer.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
104
Participants will complete a 12-week supervised dance-based exercise program consisting of three 60-minute sessions per week. Each session will include a warm-up, a main dance-based exercise component, and a cool-down. The program will combine aerobic dance activities with exercises targeting coordination, balance, mobility, and muscular function. Exercise intensity and complexity will be individually adapted according to participants' physical condition, exercise tolerance, and treatment-related symptoms.
2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute
Bratislava, Slovakia
Change in Cancer-Related Fatigue Assessed by the FACIT-Fatigue Scale
Cancer-related fatigue will be assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale. The total score ranges from 0 to 52, with higher scores indicating less fatigue (better functioning). The primary analysis will evaluate the change in FACIT-Fatigue score from baseline to the end of the 12-week intervention.
Time frame: Baseline to the end of the 12-week intervention
Change in Quality of Life
Quality of life will be assessed using the study-specified validated quality-of-life questionnaire. The relevant total and/or domain scores will be calculated according to the questionnaire scoring instructions.
Time frame: Baseline to the end of the 12-week intervention
Change in Cardiorespiratory Fitness
Cardiorespiratory fitness (VO2max) will be assessed using a bicycle exercise test. Changes in exercise capacity from baseline will be evaluated.
Time frame: Baseline to the end of the 12-week intervention
Change in Lower and Upper-Body Muscular Strength
Muscular Strength will be assessed using the functional/strength test specified in the study protocol. Changes from baseline will be evaluated.
Time frame: Baseline to the end of the 12-week intervention
Change in Gut Microbiome Diversity and Composition
Gut microbial composition will be characterized from stool samples to assess changes in the relative abundance of bacterial taxa associated with the intervention.
Time frame: Baseline to the end of the 12-week intervention
Change in Inflammatory Biomarkers
Blood samples will be analyzed for selected circulating biomarkers related to systemic inflammation. Changes in biomarker concentrations from baseline will be evaluated.
Time frame: Baseline to the end of the 12-week intervention
Change in Markers of Intestinal Permeability
Blood samples will be analyzed for selected biomarkers related to intestinal barrier function and permeability. Changes from baseline will be evaluated.
Time frame: Baseline to the end of the 12-week intervention
Long-Term Cancer-Related Fatigue
ancer-related fatigue will be reassessed after surgery using the FACIT-Fatigue scale to evaluate the persistence of intervention-related effects during follow-up. Higher scores indicate less fatigue.
Time frame: Approximately 90, 180, and 365 days after surgery
Long-Term Quality of Life
Quality of life will be reassessed during postoperative follow-up using the study-specified validated questionnaire to evaluate longer-term differences between groups.
Time frame: Approximately 90, 180, and 365 days after surgery
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