Baroreflex Sensitivity, Vascular Status, and Cardiorespiratory Fitness In Breast Cancer Survivors - A Cross-sectional Analytical Study.

Abstract

Background: Breast cancer is the most prevalent malignancy, affecting millions annually. Although advancements in therapeutic measures have resulted in diminished mortality rates, the cardiovascular and pulmonary side effects of these therapies raise clinical concerns.

Methods: This cross-sectional study evaluated baroreflex sensitivity (BRS), vascular status, pulmonary function and cardiorespiratory fitness (CRF) in 33 breast cancer survivors (BCS) aged 30-60 years, two to three years post-treatment, compared to 33 age and BMI-matched healthy females.

Results: BRS was significantly lower in BCS (p<0.05), indicating autonomic dysfunction. Pulmonary function tests revealed reduced FEV1, FVC, FEV1/FVC ratio, FEF25%-75%, and PEFR in BCS (p<0.05), suggesting impaired respiratory health. CRF was also diminished, with a significantly lower VO2 max in BCS compared to controls (31.2 ± 13.1 ml/kg/min vs. 37.4 ± 11 ml/kg/min, p=0.041). Furthermore, the Ruffier Dickson Index (RDI) was significantly higher in BCS than in controls (5.8 ± 2.2 vs. 4.6 ± 1.3, P=0.009), indicating reduced cardiovascular fitness and recovery efficiency after physical exertion. However, no significant differences were observed in carotid intima-media thickness (CIMT) or blood pressure parameters between the groups. A statistically significant association was found in RDI categories between groups (χ² = 6.554, P=0.038), indicating a difference in RDI grading distribution between healthy controls and breast cancer survivors.

Conclusion: Breast cancer survivors are at increased risk of impaired cardiac autonomic and pulmonary functions, likely as a result of the adverse effects of chemotherapy and radiotherapy. These findings highlight the need for comprehensive post-treatment monitoring and targeted rehabilitation strategies to mitigate cardiopulmonary risks and enhance the quality of life of these individuals.