2011 Breast Cancer Symposium
SAN FRANCISCO - Lower quality of life was associated with younger age,
chemotherapy usage, hormonal therapy and distress among survivors of breast
cancer, according to a study on the needs and preferences of breast cancer
survivors presented here at the 2011 ASCO Breast Cancer Symposium.
According to Daniela L. Stan, MD, of the Mayo Clinic in
Rochester, Minn., the aim of the study was to assess satisfaction with
follow-up care, needs and preferences for survivorship care and physical and
psychological health concerns.
"There are 2 million
breast cancer survivors in the United States, and that number
is expected to grow significantly," Stan said. "The cancer survivorship phase
of care has been largely neglected. The Institute of Medicine recommends
development of models of survivorship care that are patient-centered."
Stan and colleagues randomly selected 600 women who were treated at the
Mayo Clinic for breast cancer to complete a mailed survey that included 71
questions. Most of the questions were to measure distress and quality of life,
but other questions were related to the needs of breast cancer survivors,
preferences for follow-up care and health concerns. They received 329 surveys,
for a response rate of 55%.
The median age of the patients was 55 years, and the women were an
average of 3.3 years after diagnosis. Among the patients, 15% were stage 0, 35%
were stage I, 30% were stage II and 15% were stage III. As for treatment, 57%
had a mastectomy, 43% had a lumpectomy, 62% had radiation therapy, 55% had
chemotherapy and 50% had hormonal therapy.
Most patients (73%) strongly agreed that their physical and medical
needs were met, whereas only 49% strongly agreed that their psychological and
spiritual needs were met, and 67% strongly agreed that they understood their
The researchers measured the patients' interest in attending special
breast cancer survivorship clinics: 60% were interested, 17% were not
interested and 23% did not know. A face-to-face clinic was preferred by 77% of
the patients, and 86% of the patients preferred a short 1- to 3-day stay
compared with multiple trips to complete tests and consultations. In a subgroup
analysis, patients who had chemotherapy, younger patients, patients with more
distress, and patients with stage 0 or stage III disease were more interested
in the clinics.
Older patients rated the importance of mammography higher than younger
patients. Younger patients were more interested in attending clinics, more
accepting of an Internet-based model of clinics and wanted to attend clinics
earlier, within 6 months. Younger patients were also more interested in
complementary and alternative medicine, support groups, social work, exercise
and diet counseling and educational materials.
"Understanding the needs and preferences of breast cancer survivorship
is imperative in the development of patient-centered survivorship health care
programs," Stan said. "A significant portion of patients did not understand the
follow-up care plan or have their medical, psychological or spiritual needs
addressed. Distress is prevalent in breast cancer survivors, particularly in
younger patients, and is associated with a lower quality of life."
For more information:
- Stan D. #147. Presented at: 2011 Breast Cancer Symposium; Sept.
8-10; San Francisco.
Disclosure: Dr. Stan reports no relevant financial
Earn CME this spring at the HemOnc Today Breast Cancer
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