Dose-Response of Aerobic Training in Women at High-Risk for Development of Breast Cancer

Inclusion Criteria:

Women at high-risk of breast cancer as defined by one of the following:

Cytologically confirmed atypical hyperplasia
Cytologically 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 who are of child-bearing potential must have a negative pregnancy test (urine HCG or serum) within 14 days of enrollment.
Must a negative mammogram or negative breast MRI within 1 year of protocol required baseline core biopsy
Clinical breast exam interpreted as benign (not suspicious for cancer) at MSK
Performing less than or equal to 120 minutes of structured moderate-intensity or strenuous-intensity exercise per week
Able to complete an acceptable baseline CPET in the absence of high risk ECG findings or other inappropriate response to exercise as determined by the investigator.

Able to achieve an acceptable peek baseline CPET defined as by any of the following criteria:

achieving a plateau in oxygen consumption concurrent an with increase in power output;
a respiratory exchange ratio ≥ 1.10;
attainment of maximal predicted heart rate (HRmax) (i.e., within 10 bpm of age-predicted [HRmax = 220-Age[years]) Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale.

Exclusion Criteria:

Use of any selective estrogen receptor modulator or aromatase inhibitor within 6 months of randomization, including, but not limited to: (tamoxifen, raloxifene, arzoxifene, acolbifene, anastrozole, exemestane, and letrozole)
Enrollment on an interventional investigational study
Bilateral breast implants
Any newly identified breast abnormality requiring surgical excision
History of any of the following:
Invasive cancer diagnosis
DCIS
Any current invasive cancer diagnosis
Metastatic malignancy of any kind
Any other condition or intercurrent illness that in the opinion of the investigator makes the subject a poor candidate for core biopsy or the trial
Mental impairment leading to inability to cooperate.
Room air desaturation at rest ≤85%
Any of the following absolute contraindications to cardiopulmonary exercise testing and/or aerobic training:
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); or