Abstract P5-17-06: Emotional/psychological characteristics of women with triple-negative breast cancer: Do socioeconomic, demographic, and provider variables impact emotional change from diagnosis to post-treatment?
Authors: Swiger Kathleen D , Sendecki Jocelyn A , Guglielmino Janine E , Rugo Hope S , Anders Carey K , Domchek Susan M , Ahlum Hanson Arin , Dinerman Hayley , Creme Henry Catherine 
Published: May 2015

Purpose: To determine whether women with triple-negative breast cancer (TNBC) experience greater levels of emotional concern from diagnosis through post-treatment compared to women with other breast cancer subtypes.

Respondents and Methods: Women diagnosed with breast cancer responded to an 80-question online survey to identify education, information, and support needs. Respondents self-reported their breast cancer subtype and rated the emotions they experienced at diagnosis, during, and after treatment on a scale of "none," "low," "moderate," and "high." The responses of 656 women with TNBC (25.1%) were compared to 1,954 non-TNBC women (74.9%). Differences between TNBC and non-TNBC women were assessed using logistic regression at each time point. Using generalized logistic modeling, differences in score changes were categorized as decreased, same, or increased in relation to cancer subtype and other covariates.

Results: At all time points in an unadjusted analysis, TNBC women reported more fear, anxiety, and worry than non-TNBC women, although this finding was only statistically significant for fear and anxiety at diagnosis (high fear: 67% vs. 62%, p=0.046, high anxiety 68% vs. 64%, p=0.046 respectively). Change in emotions between diagnosis and treatment phase was not significantly different between cancer types. Between treatment and post-treatment, women with TNBC were significantly less likely than non-TNBC patients to report a decrease in negative emotion (fear: 58% vs. 66%; anxiety: 54% vs. 65%; worry: 53% vs. 63%, p&lt;0.001 for all). TNBC women with young children were less likely to report a decrease and more likely to report an increase in worry than non-TNBC women (decrease: 61% vs. 70%; increase 8% vs. 4%, p=0.09). A similar pattern was seen in TNBC women with income &lt;$50K annually with respect to fear (decrease: 47.3% vs. 68%, increase 11% vs. 6%, p=0.06). Cancer stage was significantly associated with emotional change. Women with TNBC stage &gt;=2 showed greater increases in negative emotion and lesser decreases in positive emotion than non-TNBC women with similarly staged cancers (p&lt;0.001). Race/ethnicity, age, education, children, living situation, or use of a mental health professional did not influence this relationship.

Conclusion: Women with TNBC experience greater fear, anxiety, and worry than women with non-TNBC subtypes at all points from diagnosis though post-treatment. While women with all breast cancer subtypes report a reduction in negative emotion over time from treatment to post-treatment, this change is less profound in TNBC women and appears to be driven nearly entirely by concern about the disease. The marginal effect on change in fear with respect to income may reflect concerns about paying for care, and increased worry in women with small children may reflect concerns about prognosis. Most strikingly, cancer stage was the strongest modifier of emotional change: TNBC women at cancer stage &gt;=2 showed the least decline in negative emotion compared to corresponding non-TNBC women. These data support the development of TNBC-specific interventions focused on these patients’ emotional needs during and after treatment.

Citation Format: Kathleen D Swiger, Jocelyn A Sendecki, Janine E Guglielmino, Hope S Rugo, Carey K Anders, Susan M Domchek, Arin Ahlum Hanson, Hayley Dinerman, Catherine Creme Henry. Emotional/psychological characteristics of women with triple-negative breast cancer: Do socioeconomic, demographic, and provider variables impact emotional change from diagnosis to post-treatment? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-17-06.