Breast Cancer

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TU_10_3414 - Identifying Survivorship Needs Among Women with Breast Cancer after Receiving Radiation Therapy

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Identifying Survivorship Needs Among Women with Breast Cancer after Receiving Radiation Therapy
K. A. Sandler1, L. Petersen2, M. L. Steinberg3, P. A. Ganz2, and S. A. McCloskey1; 1Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, 2University of California Los Angeles, Los Angeles, CA, 3University of California, Los Angeles, Los Angeles, CA

Purpose/Objective(s): There are a growing number of breast cancer survivors in the United States, many of whom report feeling “lost in transition” once their active treatment is complete. Radiation oncology is a natural setting for survivorship needs assessment and care delivery, as it is typically a time of transition from intensive primary treatment. In this study, we identify survivorship needs among a population of women undergoing radiation therapy for breast cancer to inform a radiation oncology based survivorship intervention.

Materials/Methods: Women undergoing radiation for stage 0-III breast cancer were recruited from clinic during the final week of treatment. On the final day of treatment, participants were asked to complete questionnaires designed to assess symptom burden and quality of life including the RAND SF-36; Patient-Reported Outcomes Measurement Information System (PROMIS) scales for anxiety, depression, fatigue, pain intensity, pain interference, and sleep; Breast Cancer Prevention Trial (BCPT) checklist, and Confidence in Survivorship Information (CSI). Participants were then randomized to receive a survivorship care plan (SCP) and binder of relevant survivorship resources at either 2 weeks or 6 months post treatment.

Results: A total of 62 women participated. The median age at diagnosis was 52 (range 26-78). The stage distribution was 8% stage 0, 27% stage I, 47% stage II, and 18% stage III. 69% underwent breast conservation and 31% underwent mastectomy (90% with reconstruction). Nodal evaluation was 60% sentinel node biopsy, 31% axillary dissection, and 10% none. 56% received chemotherapy. On the RAND SF-36, which is scored from 0-100 with higher scores indicating a more favorable health state, participants scored most poorly on the role limitations due to physical health scale (mean [SD] 46 [42]) and the energy/vigor scale (47.8 [24]). On the PROMIS scales, which are scored from 8-40 with a higher score less favorable, participants scored most poorly in the fatigue (20.4), sleep (19.9), and anxiety (17.2) domains. On the BCPT scales, which are scored from 0-4 with a higher score less favorable, participants scored most poorly in hot flashes (1.3) and cognitive problems (1.2). Patients were generally knowledgeable about their past diagnosis and treatment on the CSI (mean score 1.8/2), but scored poorly about the effects of disease and treatment, prevention, resources, and familial risk (mean score 0.8/2). We will present 12 month outcome data based on whether or not early vs. delayed SCP was provided

Conclusion: Women completing radiation for breast cancer have a number of factors affecting quality of life, especially fatigue and anxiety. At this point in their cancer care, most women feel confident in their knowledge about their past treatment, but are unsure about resources and prevention going forward. A personalized survivorship care plan may be of use to breast cancer survivors to reduce anxiety, improve knowledge, and increase utilization of evidence-based resources.

Author Disclosure: K.A. Sandler: None. L. Petersen: None. M.L. Steinberg: Honoraria; Accuray. P.A. Ganz: None. S.A. McCloskey: None.

Kiri Sandler, MD

UCLA

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