Abstract P4-12-07: Incremental benefit of an interdisciplinary care team model for resource identification in adolescents and young adults with breast cancer
Authors: Gruen Leah , Lee-Miller Cathy , Parkes Amanda 
Published: March 2022

Background: Breast cancer is the most common cancer seen in adolescents and young adults (AYAs, defined as patients aged 15-39 years). As conventional care models insufficiently address their unique needs, AYA programs have been established. There is limited data, however, to support the most effective AYA care model, particularly for individual AYA tumor types. In the context of survey data at the University of Wisconsin Carbone Cancer Center (UWCCC) that showed that AYAs with breast cancer had decreased satisfaction with AYA resources despite higher self-identified supportive care service utilization as compared with other tumor types, we sought to compare resource identification in AYAs with breast cancer versus other tumor types. Methods: We identified patients seen in the UWCCC AYA Oncology program between 1/21/2021-5/27/2021. Patients in this program have a one-on-one clinic visit with an AYA physician followed four days later by case presentation at an AYA interdisciplinary team (IDT) meeting. We conducted retrospective chart review to evaluate AYA-specific resources (see services listed in table 1) that were utilized prior to the AYA clinic visit compared to novel AYA-specific resources identified by the one-on-one AYA clinic visit versus the AYA IDT meeting. Resources identified by the AYA Oncology program (clinic visit + IDT) had to be novel from those already used by the patient. We specifically compared resources for AYAs with breast cancer versus other tumor types to identify unique needs and resource identification for AYAs with breast cancer. Results: We identified 35 patients seen by the UWCCC AYA Oncology program, including 10 patients with breast cancer (10/35, 29%) with a mean age at diagnosis of 33.4 years. Reviewing AYA-specific resources obtained prior to being seen in the UWCCC AYA Oncology program, AYAs with breast cancer saw an average 2.0 AYA-specific resources/patient as compared with an average 2.9 AYA-specific resources/patient in AYAs with other tumor types. As seen in table 1, a higher number of novel AYA-specific resources were identified during the one-on-one AYA physician clinic visit for AYAs with other tumor types (average 2.8 novel AYA-specific resources/patient) versus AYAs with breast cancer (average 2.0 novel AYA-specific resources/patient). Most notably, the AYA IDT meeting showed a higher incremental benefit in AYAs with breast cancer, with an average of 2.9 novel AYA-specific resources identified through the AYA IDT meeting for breast cancer patients versus 1.6 additional resources identified for AYAs with other tumor types. Considering all resources identified by the AYA Oncology program (clinic visit + IDT), AYA breast cancer patients had an average of 4.9 novel AYA-specific resources identified per patient versus an average of 4.4 novel resources for AYAs with other tumor types. Conclusions: Consistent with our survey findings, we found high resource needs in all AYAs, with a slightly higher number of novel AYA-specific resources identified by our AYA Oncology program for AYAs with breast cancer versus other tumor types. Most significantly, AYA-specific resources for breast cancer patients were best identified by the interdisciplinary care team. This novel study reports objective data to support the critical importance of incorporating an interdisciplinary team model in the care of AYAs, particularly those with breast cancer.

Table 1.Novel Resources Identified During AYA One-On-One Clinic Visit versus AYA IDT Meeting (n=35)AYA-Specific Resources n (%)One-On-One Clinic Visit Breast Cancer (n=10)One-On-One Clinic Visit Other Tumor Types (n=25)IDT Meeting Breast Cancer (n=10)IDT Meeting Other Tumor Types (n=25)Social Work1 (10)4 (16)2 (20)4 (16)Fertility & Sexual Health1 (10)9 (36)2 (20)3 (12)Genetics1 (10)7 (28)4 (40)2 (8)Psychology & Psychiatry3 (30)11 (44)2 (20)2 (8)Physical & Occupational Therapy3 (30)5 (20)5 (50)5 (20)Vocational Resources0 (0)5 (20)1 (10)2 (8)Peer Support5 (50)14 (56)3 (30)5 (20)Nutrition3 (30)6 (24)5 (50)4 (16)Other3 (30)12 (48)5 (50)12 (48)Average Novel Resources/Patient2.02.82.91.6

Citation Format: Leah Gruen, Cathy Lee-Miller, Amanda Parkes. Incremental benefit of an interdisciplinary care team model for resource identification in adolescents and young adults with breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-12-07.