Abstract P5-13-17: Simplifying survivorship surveillance
Authors: Pories SE , Myers LE , Dusenbery KL 
Published: March 2017

Breast cancer survivors represent 4 of 10 female cancer survivors in the United States, comprising an estimated 3.1 million women living with breast cancer in the US. Addressing survivors' unique post-treatment needs is critical to providing quality health care. In fact, Survivorship Care Plans are now required for all breast cancer patients by the National Accreditation Program for Breast Centers. To ensure that we meet recommended guidelines and provide comprehensive survivorship care, we have created a computerized treatment summary and developed a unique simple assessment tool to be incorporated at the patient's survivorship visit. The goal is to increase awareness of short and long term side effects post treatment and develop a plan to address the patient's needs. The visits are carried out by the nurse practitioners and average 60 minutes.

Data from the first 20 patients in our new program show that most are age 40-49 (30%), 25% are age 60-69, 20% age 50-59, 20% age 70-79 and 5% age 30-39. The majority of patients (65%) were treated with breast conserving surgery and sentinel node biopsy. Most women who had a mastectomy also had reconstruction (83%). The majority (95%) had lymph nodes removed as part of their cancer surgery and 30% report a sensation of tightness or swelling on the side where lymph nodes were resected. The majority (90%) are receiving hormonal therapy and 40% also had chemotherapy. A majority (75%) reported side effects from hormonal therapy such as hot flashes, joint pain, or vaginal dryness. 15% of patients reported concerns with sexual function or sexual activity. Over a third of patients (35%) felt anxious, nervous, or on edge, 25% of patients reported that they had little interest or pleasure in doing things, 15% felt down, depressed or hopeless. Memory problems were reported by 30% of patients, 25% complained of difficulties multitasking or paying attention and 10% reported their thinking seemed slow. Over half of the patients (55%) reported problems with insomnia, 30% complained that fatigue interfered with their usual activities, 15% had persistent fatigue, and 15% reported excessive sleepiness. 25% complained of ongoing discomfort related to their cancer treatment but only 5% felt the pain interfered with their usual activities. There were no reports of difficulties with activities of daily living. However, 25% had concerns about their body image and appearance since cancer treatment. Most patients (90%) report eating a well-balanced diet and 65% engage in regular physical activity yet 45% of patients are concerned about their weight. Only 5% are smokers, 40% have up to 3 alcoholic beverages a week, 20% have 4-7 drinks a week, 10% drink more than 7 alcoholic beverages a week, and 25% do not drink alcohol at all. Only 50 percent had a recent pap smear, 45% had a recent colonoscopy, 60% had a recent bone density, and 80% see an ophthalmologist regularly. Most patients (60%) did not need referrals for other services, but 5% were sent for mental health services, 10% for consultation with the plastic surgeon, 10% for consultation regarding sexual functioning, 5% for physical therapy, and 5% for social work intervention.

We have had an overwhelmingly positive response from patients to the survivorship visits and will continue to expand this useful and effective program.

Citation Format: Pories SE, Myers LE, Dusenbery KL. Simplifying survivorship surveillance [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-17.