The Breast Cancer Prevention and Longevity Lab focuses on developing low-toxicity strategies to reduce breast cancer risk in high-risk women and prevent recurrence in women with non-invasive or invasive disease. The group’s work is guided by the principle of the minimum effective dose: identifying interventions that deliver meaningful preventive benefit while minimizing side effects and improving long-term acceptability and adherence. Key research areas include low-dose endocrine prevention, alternative dosing schedules of endocrine agents, drug repurposing, metabolic interventions and biomarker-driven clinical trials.
The group aims to integrate clinical prevention, translational biomarkers, lifestyle and metabolic risk modulation, and implementation research to make breast cancer prevention more personalized, tolerable and accessible. The lab works across the prevention–treatment–survivorship continuum, with particular interest in high-risk populations, screening and early detection, risk prediction with AI, endocrine prevention, treatment de-escalation, adherence, holistic approach to retain quality of life and practice changing studies to inform clinical guidelines and health policy.
Our main research areas include:
• Developing innovative strategies for breast cancer prevention and risk reduction
• Advancing biomarker-driven prevention and early intervention
• Investigating lifestyle and metabolic approaches to cancer prevention and longevity in survivors
Our Clinical studies examine the potential of physical exercise as a concurrent therapy along with standard care to counteract the overall side effect burden of breast cancer treatment resulting from fatigue, cardiotoxicity, neuropathies, and sleep disturbances. Examples of our clinical research include a 4 to 6 month randomized controlled trial that is examining the impact of supervised exercise on Ki67 among breast cancer patients undergoing neoadjuvant treatment (The Neoadjuvant Exercise Oncology Program – NEO -Program). We have other clinical trials in preparation to 1) examine whether resistance exercise can improve tolerability to cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with endocrine therapy in estrogen receptor-positive (ER+)/Human Epidermal Receptor 2-negative (HER2-) breast cancers and 2) to determine whether physical exercise can improve sleep patterns during adjuvant hormone therapy in hormone-dependent (HR+) breast cancer.
Epidemiological studies use already existent data resources to expand our understanding of the role of physical activity and sleep in the etiology of cancer. Epidemiological studies are important to determine the distribution of risk factors for cancer such as physical inactivity or poor sleep in the population and quantify dose-response relationships between physical activity, sleep, and cancer risk and cancer survivorship. Examples of ongoing studies include our 1) examinations of the distribution of activity levels in the Portuguese population (n=8000 adults) using wearable measures of step counts and stepping intensity, and 2) examinations of associations between wearable-based sleep patterns and risk of mortality among adults (n=5000 adults).
Digital Health studies in our lab are examining the clinical value of wearable technology in oncology for the timely identification and monitorization of cancer treatment side effects including fatigue. These studies will allow for more individualized and proactive cancer treatments. We are particularly interested in identifying digital biomarkers of cancer outcomes using physical activity, exposure to light, and sleep measures, extracted from consumer and research-grade wearables. One example of a digital health study that we conducted recently includes the characterization of sleep patterns using a contactless sleep device among 25 women undergoing neoadjuvant chemotherapy and whose sleep patterns were monitored for 4 consecutive months throughout the entire duration of their treatment.
Group Leader
Breast Department Director
Low-dose tamoxifen in non-invasive breast neoplasia: long-term results from an individual participant data pooled analysis.
Sara Gandini, Aliana Guerrieri-Gonzaga, Davide Serrano, Roberta Rizzo, Matteo Lazzeroni, Matteo Puntoni, Tania Buttiron Webber, Gaetano Aurilio, Harriet Johansson, Alessio Carbone, Livia Giordano, Maria Digennaro, Laura Cortesi, Francesco Millo, Katia Cagossi, Giuseppe Aprile, Patrizia Serra, Elisa Gallerani, Marcio Debiasi, Berta Sousa, Pedro Gouveia, Bernardo Bonanni, Andrea De Censi
Journal of Clinical Oncology
doi.org/10.1200/JCO-26-00841
Publication Date: 2026
Predictive Effect of IGFBP-3 on Low-Dose Tamoxifen Efficacy in Noninvasive Breast Cancer in the Phase III TAM-01 Trial
Harriet Johansson, Debora Macis, Martino Oliva, Matteo Puntoni, Eva Blondeaux, Aliana Guerrieri-Gonzaga, Valentina Aristarco, Irene Maria Briata, Tania Buttiron-Webber, Luca Boni, Matteo Lazzeroni, Davide Serrano, Livia Giordano, Maria Digennaro, Laura Cortesi, Francesco Millo, Katia Cagossi, Giuseppe Aprile, Fabio Falcini, Elisa Gallerani, Bernardo Bonanni, Andrea De Censi
Clinical Cancer Research
doi.org/10.1158/1078-0432.CCR-24-2987
Publication Date: 2025
Efficacy of Alternative Dose Regimens of Exemestane in Postmenopausal Women With Stage 0 to II Estrogen Receptor-Positive Breast Cancer: A Randomized Clinical Trial Davide Serrano, Sara Gandini, Parjhitham Thomas, Katherine D Crew, Nagi B Kumar, Lana A Vornik, J Jack Lee, Paolo Veronesi, Giuseppe Viale, Aliana Guerrieri-Gonzaga, Matteo Lazzeroni, Harriet Johansson, Mauro D’Amico, Flavio Guasone, Stefano Spinaci, Bjørn-Erik Bertelsen, Gunnar Mellgren, Isabelle Bedrosian, Diane Weber, Tawana Castile, Eileen Dimond, Brandy M Heckman-Stoddard, Eva Szabo, Powel H Brown, Andrea De Censi, Bernardo Bonanni JAMA Oncology doi.org/10.1001/jamaoncol.2023.0089 Publication Date: 2023
Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Recurrence in Breast Noninvasive Neoplasia: A 10-Year Follow-Up of TAM-01 Study
De Censi A, Puntoni M, Guerrieri‐Gonzaga A, Caviglia S, Avino F, Cortesi L, Taverniti C, Pacquola MG, Falcini F, Gulisano M, Digennaro M, Cariello A, Cagossi K, Pinotti G, Lazzeroni M, Serrano D, Branchi D, Campora S, Petrera M, Buttiron Webber T, Boni L, Bonanni B
Cochrane Central Register of Controlled Trials
Publication Date: 2019
Dual Effect of Metformin on Breast Cancer Proliferation in a Randomized Presurgical Trial. Journal of Clinical Oncology
Bernardo Bonanni, Matteo Puntoni, Massimiliano Cazzaniga, Giancarlo Pruneri, Davide Serrano, Aliana Guerrieri-Gonzaga, Alessandra Gennari, Maria Stella Trabacca, Viviana Galimberti, Paolo Veronesi, Harriet Johansson, Valentina Aristarco, Fabio Bassi, Alberto Luini, Matteo Lazzeroni, Clara Varricchio, Giuseppe Viale, Paolo Bruzzi, Andrea De Censi
Journal of Clinical Oncology
doi:10.1200/JCO.2011.39.3769
Publication Date: 2012
BabyTEARS
Sponsor: Breast Cancer Research Foundation
Principal Investigator: Andrea De Censi
Randomized double-blind phase II trial comparing baby tamoxifen with baby exemestane in postmenopausal women at high risk for breast cancer. This project directly builds on Prof. De Censi’s work on low-dose endocrine prevention and treatment tolerability.
TAM-01 / BabyTAM
Sponsor: PRR Project/ FIRST GLOBAL SOLUTION
Principal Investigator: Andrea De Censi
Phase III trial of low-dose tamoxifen in women with breast intraepithelial neoplasia. This landmark prevention program demonstrated the potential of tamoxifen 5 mg/day to reduce recurrence of DCIS and high-risk breast lesions with limited toxicity, supporting the broader concept of minimum effective dosing in breast cancer prevention.
TOLERANT Study
Sponsor: Champalimaud Foundation
Principal Investigators: Andrea De Censi
Low-dose Tamoxifen and Lifestyle changes for breast cancer prevention: a randomised phase II biomarker trial in women at increased risk for breast cancer.
Disclaimer: contact us for more information about these studies or if you wish to know more about other ongoing work we have at our lab.
Our priority at the Champalimaud Foundation is to develop a structured and personalized offer of exercise programs for all patients diagnosed with cancer. To achieve this goal, we designed RELIEVE – an innovative program that will create a personalized referral and exercise prescription fully integrated into the clinical care pathway for patients followed at the Champalimaud Clinical Centre. RELIEVE will be implemented at our new exercise facility The SmartGym, thanks to a generous donation from The Good Bottle.
The SmartGym will be equipped with Technogym latest technology including the Technogym A.I. powered checkup assessment hardware and software that includes a cloud ecosystem to securely store and manage all data collected during the exercise sessions. As part of RELIEVE, we will also implement an individualized and passive monitoring system for behaviors of daily life including physical activity and sleep, outside the clinical setting. RELIEVE will inform our patients and our science about which exercise programs can help cancer patients the most.
There is established evidence that physical exercise is a key player for cancer prevention and for improving the prognosis and quality of life of people who have cancer. Our lab organized the conference Moving Beyond, which took place at the Champalimaud Foundation on April 3 and 4 2025 and gathered world scientific leaders in the field of “exercise oncology”.
During the two-day conference, we interviewed a series of invited speakers on the benefits of physical activity for cancer prevention and treatment and asked speakers to share some of the key scientific advances in exercise oncology.
Watch the video and hear what they had to say.