Background and Objectives: Adjuvant treatment with aromatase inhibitors (AIs) in breast cancer (BC) survivors can cause adverse effects such as metabolic syndrome (MS) (insulin resistance, central obesity, atherogenic dyslipidemia, and hypertension) associated with morbidity and premature mortality. We evaluate the effect of a multimodal program based on physical exercise and health education on MS and health-related quality of life (QoL) in postmenopausal women with BC under AIs. Methods: A total of 56 postmenopausal women, diagnosed with BC, aged 60 years or older (mean age 67.2 years) and on hormonal treatment with AIs, were included in the multimodal physical exercise and health education program, and evaluated before and after their participation. The assessment of the five criteria of the MS included the following: waist circumference, high blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol. Two main instruments were used to evaluate the impact of the intervention on QoL: the EORTC QLQ C30 (questionnaire for cancers in general) and the EORTC QLQ BR23 (specifically for breast cancer patients). The EuroQol 5D (EQ-5D) was also used to compare these results. Results: The percentage of women meeting the MS criteria was 37.7% at baseline and fell to 15.1% at 3 months after the intervention (p = 0.02). The intervention significantly reduced hypertension (p < 0.001), central obesity (p < 0.001), and the concentration of triglycerides (p = 0.016). No significant changes were observed in fasting glucose and HDL concentration. A statistically significant improvement was found in QoL (on both the QLQ30 and BR23 scales). A multivariate regression model analysis identified marital status (being married) (95% CI: 1.728–131.615, p = 0.014), and percentage of attendance at health education sessions (95% CI: 1.010–1.211, p = 0.029) as positive predictive variables of improvement in MS. Conclusions: The implementation of multimodal, community-based programs of physical exercise and health education improve the prevalence of MS and specific criteria of MS and QoL in postmenopausal women with breast cancer receiving AI treatment.

Background/Objectives: Treatment with aromatase inhibitors can worsen frailty syndrome and psychological symptoms in women diagnosed with breast cancer (BC) receiving these drugs to prevent cancer recurrence. We analyze whether postmenopausal women with localized BC receiving aromatase inhibitors (AIs) treatment can achieve improvements in their mental health and their level of frailty through a multimodal program that includes supervised physical exercise and health education workshops. Methods: A total of 52 postmenopausal women with a prior diagnosis of BC and receiving hormonal treatment with AIs were included in the multimodal physical exercise and health education program and evaluated before and after it. The assessment included the following five frailty syndrome (FS) criteria: involuntary weight loss, weakness, low physical activity, slow gait speed, and low muscle strength. Mental health was assessed using the Goldberg scale, with its subscales for anxiety and depressive symptoms. The Athens scale was used to assess subjective sleep quality. Results: There was a significant difference in the number of robust, pre-frail and frail women after the program compared to the baseline. Six women did not fulfill any criteria for (robust) FS before the program (11.5%), and thirty-three women (63.5%) after the program did not fulfill any criteria for FS. A total of 33 (63.5%) women met one or two FS criteria (pre-frail) before the program, and 18 (34.6%) met one or two FS criteria after the program; thirteen (25%) women met three or more FS criteria (frail) before the program and one (1.9%) after it (p < 0.001). A statistically significant improvement on the Goldberg scale was observed (on both the subscales for anxiety and depressive symptoms) (p < 0.001). A statistically significant improvement was also noted on the Athens insomnia scale (p < 0.001). A multivariate regression model analysis identified marital status (being married) (p = 0.047, beta coefficient= −0.249, 95% CI −1.4844–−0.14) and the percentage of attendance at training sessions (p = 0.041, beta coefficient = −0.290, 95% CI 0.104–0.002) as associated variables, with a lower score on the Goldberg depression subscale. Conclusions: Mental health and frailty, common in postmenopausal women diagnosed with BC on hormonal treatment with AI, can be improved with multimodal programs of supervised physical exercise and health education.

Background: Fibroblast growth factor 21 (FGF21) is a peptide hormone that is synthesized by several organs and regulates energy homeostasis, including reducing fat mass and lowering hyperglycemia, insulin resistance and dyslipidemia. It also increased metabolic syndrome (MS) and cardiovascular risk in breast cancer (BC) survivors treated with aromatase inhibitors (AIs) aimed at reducing cancer recurrence. We evaluated whether blood FGF21 concentration is associated with MS and its five criteria in postmenopausal women treated with AIs, and whether this persists after multimodal interventions that reduce MS. Methods: A quasi-experimental longitudinal study in 31 postmenopausal women with localized BC on Ais, assessed via a 12-week multimodal program. Their MS was evaluated per the NCEP-ATP III guidelines (waist circumference, blood pressure, fasting glucose, triglycerides, HDL-cholesterol). Plasma FGF21 was measured pre/post-intervention via fasting blood samples, centrifugation, and ELISA assay. Results: Pre-intervention FGF21 median: 377.62 pg/mL (38.40–1616.42). Plasma FGF21 concentrations positively correlated with MS criteria number pre- and post-intervention (all p < 0.05). Linear regression confirmed pre-intervention MS criteria (β = 127.262, p = 0.006) and antihypertensive drugs as predictors of post-FGF21 levels. Analysis of individual MS criteria revealed significant associations with blood pressure (p = 0.028 and p = 0.022 for systolic and diastolic pressure, respectively) and fasting glucose changes (p = 0.008). Conclusions: Plasma FGF21 may act as a biomarker for monitoring exercise-based interventions which reduce MSs, particularly hypertension and hyperglycemia, in AI-treated BC survivors.