% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Schmidt:300247,
      author       = {M. Schmidt$^*$ and A. E. Hiensch and J. Depenbusch and E.
                      M. Monninkhof and J. Belloso and D. Clauss and N. Gunasekara
                      and M. Trevaskis and H. Rundqvist and J. Wiskemann and J.
                      Müller and M. G. Sweegers and A. Schneweiss and R. Altena
                      and J. Kufel-Grabwska and R. M. Bijlsma and L. van
                      Leeuwen-Snoeks and D. T. B. Huinink and G. Sonke and S.
                      Brandner and P. Savas and Y. Antill and M. White and N.
                      Ancizar and E. van der Wall and N. K. Aaronson and E. Senkus
                      and A. Urruticoechea and E. M. Zopf and W. Bloch and M. M.
                      Stuiver and Y. Wengström and A. M. May and K.
                      Steindorf$^*$},
      title        = {{I}mpact of exercise on sexual health, body image, and
                      therapy-related symptoms in women with metastatic breast
                      cancer: {T}he randomized controlled {PREFERABLE}-{EFFECT}
                      trial.},
      journal      = {International journal of cancer},
      volume       = {157},
      number       = {3},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2025-00708},
      pages        = {490-503},
      year         = {2025},
      note         = {#EA:C110#LA:C110# / 2025 Aug 1;157(3):490-503},
      abstract     = {The understanding and treatment of sexual health problems,
                      impaired body image, and other non-life threatening but
                      burdensome symptoms of women with metastatic breast cancer
                      (mBC) is still insufficient. We studied the factors
                      associated with such symptoms and investigated whether these
                      problems could be alleviated by a structured exercise
                      intervention. In the multinational PREFERABLE-EFFECT study,
                      355 women with mBC were randomly assigned to usual care (n =
                      178) or a 9-month supervised exercise program (n = 177).
                      Breast cancer-specific functions and symptoms (EORTC
                      QLQ-BR42) were assessed at baseline, 3, 6 (primary
                      timepoint), and 9 months. Linear regression models and
                      linear mixed models for repeated measures were calculated.
                      At baseline, participants were 55.4 ± 11.2 years old,
                      $52.4\%$ were undergoing endocrine therapy, and $25.4\%$
                      chemotherapy. Baseline sexual functioning was low, with
                      $94.3\%$ reporting no or little sexual activity. Age and
                      depressive symptoms were negatively associated with sexual
                      functioning. Among sexually active women, $46.2\%$ felt no
                      or little sexual enjoyment and $37.3\%$ suffered from
                      vaginal dryness. Body image was reported as low by $23.7\%.$
                      Exercise significantly improved sexual functioning (6-months
                      between-group difference (BGD) = 5.6, $95\%$ CI [1.9, 9.4],
                      effect size (ES) = 0.28) and vaginal symptoms (BGD = -7.1
                      [-11.7, -2.5], ES = 0.25), compared to usual care. Effects
                      on body image were marginal (BGD = 4.0 [-0.2, 8.3], ES =
                      0.14). Among participants undergoing chemotherapy (n = 90),
                      exercise reduced chemotherapy side-effects (BGD = -8.2
                      [-15.4, -1.0], ES = 0.48). In conclusion, women with mBC
                      often experience sexual and vaginal problems and other
                      treatment-related side-effects. A 9-month supervised
                      exercise program vs. control was effective in improving
                      sexual functioning and vaginal symptoms among women with
                      mBC.},
      keywords     = {exercise (Other) / metastatic breast cancer (Other) /
                      quality of life (Other) / sexual health (Other) / supportive
                      care (Other)},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40181524},
      doi          = {DOI:10.1002/ijc.35429},
      url          = {https://inrepo02.dkfz.de/record/300247},
}