Abstract P5-10-01: Triaging cancer-related distress at the time of breast cancer (BC) diagnosis
Authors: Rynar Lauren Z. , Knox Blaine A. , Wendell Kristen B. , Mumby Patricia B. , Albain Kathy S. , Grace-Louthen Cathy , Mai Hahn P. , Robinson Patricia A. , Lo Shelly S. 
Published: March 2020

Background: In accordance with Commission on Cancer (CoC) Standard 3.2, the Loyola University Chicago multidisciplinary Breast Oncology Center evaluates every new patient (pt) for cancer-related concerns and makes supportive oncology referrals accordingly (CoC Standard 3.2). We previously reported that pts with newly diagnosed early-stage BC experience high levels of physical and emotional distress (Rynar 2019, ASCO abstract 269661). This study expands upon those findings by examining relationships between psychological distress and other cancer-related concerns and referrals to supportive services in a larger cohort of pts with newly diagnosed BC. Methods: The "Patient Screening Questions for Supportive Care" (Coleman Supportive Oncology Collaborative, 2017), an aggregate of validated screening tools, was implemented across 200 new pts from April 2018 thru August 2018. Demographic information and supportive oncology referrals were obtained from medical records. Descriptive statistics and chi-square were used to assess frequencies and relationships among variables. Results: 200 female pts aged 26-94 (mean (SD) = 61.39(12.90)) completed the screening tool; 16.5% had Stage 0, 40% Stage I, 34.5% Stage II, 4.5% Stage III, 2.0% Stage IV. Commonly reported psychosocial and physical complaints included concerns about work and paying for medical care, poor sleep, tingling in hands or feet, and concerns about weight gain. 47% of pts met the threshold for referral to psychology based on a positive screen for anxiety (n=65) or depression (n=28); the majority (92.8%) had at least 1 contact with a psychologist within 12 days. 51.5% of pts screened positive for a practical need triggering a referral to social work; 72.8% of consults were completed within 3 days. 27% had nutrition concerns triggering referrals to dietician services; 77.8% completed contact within 3 days. Pts who screened positive for anxiety were significantly more likely (p&lt;.01) to also have ≥2 physical concerns, nutrition concerns, fatigue, and concerns about physical function (p=.04). Screening positive for depression was significantly associated (p&lt;.01) with ≥2 physical concerns, family concerns, spiritual concerns, fatigue, and pain (p=.03). Conclusions: Newly diagnosed BC pts who screen positive for anxiety or depression are more likely to report concerns across multiple biopsychosocial domains. This finding lends support for CoC, NCCN, and ASCO supportive care guidelines to evaluate and address patient reported concerns beyond psychological distress. Further, we highlight the importance of assessment and triage at the start of the cancer care continuum. Future studies should reevaluate distress at pivotal points in care to determine the impact of early interventional supportive oncology services in this population.

Citation Format: Lauren Z. Rynar, Blaine A. Knox, Kristen B. Wendell, Patricia B. Mumby, Kathy S. Albain, Cathy Grace-Louthen, Hahn P. Mai, Patricia A. Robinson, Shelly S. Lo. Triaging cancer-related distress at the time of breast cancer (BC) diagnosis [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-10-01.