PurposeThis observational study was designed to measure baseline energy parameters and body composition in early-stage breast cancer patients, and to follow changes during and after various modalities of treatment. This will provide information to aid in the development of individualized physical activity intervention strategies.MethodsPatients with newly diagnosed stage 0–III breast cancer were enrolled into three cohorts: A (local therapy alone), B (endocrine therapy), or C (chemotherapy with or without endocrine therapy). At baseline, 6 months, and 12 months, subjects underwent a stationary bicycle protocol to assess power generation and DEXA to assess body composition.ResultsEighty-three patients enrolled. Patients had low and variable levels of power generation at baseline (mean power per kilogram lean mass 1.55 W/kg, SD 0.88). Power normalized to lean body mass (W/kg) decreased significantly, and similarly, by 6 months in cohorts B (1.42–1.04 W/kg, p = 0.008) and C (1.53–1.18 W/kg, p < 0.001). In all cohorts, there was no recovery of power generation by 12 months. Cohort C lost lean body mass (− 1.5 kg, p = 0.007), while cohort B maintained lean body mass (− 0.2 kg, p = 0.68), despite a similar trajectory in loss of power. Seven patients developed sarcopenia during the study period, including four patients who did not receive any chemotherapy (cohort B).ConclusionsThe stationary bike protocol was feasible, easy, and acceptable to patients as a way to measure energetic capacity in a clinical setting. Early-stage breast cancer patients had low and variable levels of power generation, which worsened following primary therapy and did not show evidence of ‘spontaneous recovery’ by 12 months. Effective physical activity interventions will need to be personalized, accounting for both baseline ability and the effect of treatment.Electronic supplementary materialThe online version of this article (10.1007/s10549-018-4924-6) contains supplementary material, which is available to authorized users.

To realize high efficiency in parallel with low cost, a light‐trapping rear texture was proposed to be implemented in substrate‐free thin‐film multijunction (MJ) cells. A detailed‐balance theory was formulated taking account of the finite light absorption in thin subcells. Such presented absorption model is general and useful to optimize the subcell thickness for MJ solar cells with light‐trapping design. It is applied for InGaP/GaAs/InGaAs triple‐junction solar cells to simulate subcell photocurrents and to obtain the current‐matching (minimum requisite) subcell thicknesses combinations. Furthermore, the detailed‐balance conversion efficiency was estimated for both radiative limit and the cases with below‐unity internal radiative efficiency. For InGaP/GaAs/InGaAs MJ cells with InGaP subcell thickness less than 600 nm, adding a random‐textured rear reflector can enhance light absorption so significantly that over 90% of InGaAs‐cell thickness and even 50% of GaAs‐cell thickness would be cut without any penalty in conversion efficiency, compared with the subcell thicknesses in traditional MJ cells with flat rear reflectors. Additionally, the thickness combination, (InGaP, GaAs, and InGaAs) = (450 nm, 333 nm, and 26 nm), is recommended to achieve both high conversion efficiency and low material cost. This work provides a very important theoretical guidance for the development on low‐cost and high‐efficiency MJ devices.

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