Abstract P2-12-05: Psychological status of early breast cancer (EBC) patients (pts) after surgery and before the starting of aromatase Inhibitors (AIs). Results of a single-institution, prospective study
Authors: Cazzaniga Marina E , Valentini Annalisa , Gallina Francesca , Riva Francesca , Crippa Alessandra , Tagliabue Marco , Cicchiello Federica , Cortinovis Diego , Bidoli Paolo 
Published: May 2015

BACKGROUND

AIs are the milestone adjuvant treatment for postmenopausal early HR+ BC pts. Non-steroidal AIs induce a significant oestrogen deprivation, responsible in approximately 40% of the pts for muscle-skeletal adverse events (MSKs) and for discontinuation in 25%. The present study aims to evaluate the impact of the diagnosis communication and of the need for AI therapy on the future development of MSKs events in a prospective cohort of EBC pts.

PATIENTS AND METHODS

The analysis of patients’ psychological attitude was conducted by using 3 different tests: SCL 90-r for psychological symptoms, SF-36 for the self-perception of the health status and COPE-NVI for evaluation of coping. After a full explanation of the AIs potential adverse events by the oncologist, the questionnaires were self-administered with the support of a dedicated psychologist at the moment of the first visit (T0). For the future correlation between baseline psychological attitude and the development of AI-related events, the presence and the intensity of pain were measured by NRS 11-points scale and by Tender Points (TPs) evaluation. Pearson correlation analysis was used to calculate correlations between Pain Scale, Physical Synthetic Index of Sf-36 and NRS/TRPs scores. Wilcoxon’s Test was used to compare baseline scores with subsequent ones.

RESULTS

From October 2012 to April 2013, 70 EBC pts entered the study. Exclusion criteria included severe osteoporosis or other co morbidities that contraindicate therapy with AIs and documented diagnosis of psychosis or cognitive deterioration. Median age was 64.8 years (43-88). The vast majority of the pts (584.3%) presented stage IA-IIA disease. Fifteen pts aged less than 55 years were menopausal, 13 have previously received chemotherapy as part of the planned adjuvant programme. Thirty-four pts (48.6%) had a baseline NRS&gt;0 and 18 NRS&gt;5; 26 pts presented at least 1 positive TP. Regarding the SCL 90-r analysis, all the pts have reported standardized scores within the normal ranges for somatization, anxiety and phobic anxiety. The analysis of SF-36 questionnaires indicated that pts showed a significant lower score in comparison to the reference population in the ISF Index (44.17 vs 48.7) and in the Physical Health Scale (47.5 vs 74.13). These differences could suggest a greater difficulty to do daily activities and a worse global index of self physical perception

At baseline, there was a statistically significant correlation between Physical Pain Scale of SF-36 and NRS Pain score (p=0.001) and between Physical Synthetic Index of SF-36 and NRS Pain Score (p&lt;0.001). No differences have been observed in the COPE NVI questionnaires between the studied population and the reference one.

CONCLUSION

Early BC pts who are candidate for endocrine adjuvant therapy with AIs often present an impairment in terms of physical activity (daily and working) and perception of physical pain. The analysis of these parameters along the 1st year of AI therapy and their correlation with MSK adverse events onset is ongoing.

Citation Format: Marina E Cazzaniga, Annalisa Valentini, Francesca Gallina, Francesca Riva, Alessandra Crippa, Marco Tagliabue, Federica Cicchiello, Diego Cortinovis, Paolo Bidoli. Psychological status of early breast cancer (EBC) patients (pts) after surgery and before the starting of aromatase Inhibitors (AIs). Results of a single-institution, prospective study [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 P2-12-05.