Abstract P5-17-03: Breast cancer in young women in Canada: A needs assessment
Authors: DeCoteau MJ , Mercado MG , Ginsberg S , Dhir V , Brezden-Masley C 
Published: February 2018

Abstract
Objective: A Needs Assessment was conducted by Rethink Breast Cancer to assess age-related differences in experiences for breast cancer patients. This was the first national survey to identify the needs and current gaps in care for younger breast cancer patients. The report, published in March 2013, provided critical evidence-based information and benchmarks to stakeholders on the associated challenges. The following data supplements the main findings presented at the 2013 SABCS by providing a descriptive overview of the differences in breast cancer experiences between younger (≤45 years of age) and older (&gt;45 years of age) women.
Methods: From June to October 2011, an online bilingual (English and French) quantitative survey was open to Canadian women who had a diagnosis of breast cancer (initial or recurrence) in the prior 6 years. The survey focused on their pre-diagnosis, diagnosis, treatment, and post-treatment experiences. 574 women responded to the survey: 372 (65%) aged ≤45 years and 202 aged &gt;45 years. The differences in responses between the younger and older respondents was analyzed using the Pearson's Chi-Square test (α = 0.05).
Results: Finding a lump (64.3 vs 39.6%; p &lt;.01) and experiencing pain or discomfort in the breast (24.5 vs 14.4%; p &lt;.01) were significantly more likely to cause concerns in younger women. Older women were significantly more likely to be concerned by results from a screening test/mammogram (45.0 vs 8.1%; p &lt;.01). It is plausible that younger women do not receive mammograms as often as their older counterparts. Of the 319 women that found a lump, self-examination (38.6%) was the most frequent method of discovery. However, this was significantly more likely among older rather than younger women (51.3 vs 34.3%; p = 0.02). Follow-up appointments for future reassessment were significantly more likely to be scheduled with younger rather than older women (15.1 vs 5.0%; p = 0.02). With respect to treatment, younger women were significantly more likely than older women to be recommended chemotherapy (81.7 vs 67.3%; p &lt;.01), targeted therapy (21.0 vs 10.9%; p &lt;.01), bilateral mastectomy (17.2 vs 8.9%; p &lt;.01), breast reconstruction (30.9 vs 14.4%; p &lt;.01), node dissection (37.9 vs 23.3%; p &lt;.01), oophorectomy (10.8 vs 5.0%; p = 0.02), and hysterectomy (7.8 vs 2.0%; p &lt;.01). Transitioning from regular to occasional monitoring by a healthcare team was reported to be very or somewhat difficult (59.1 vs 41.8%; p &lt;.01) for younger instead of older women, while older women were significantly more likely to report little to no difficulty with this transition (58.2 vs 40.9%; p &lt;.01).
Conclusions: The Needs Assessment demonstrated significant age-related differences in almost all aspects of breast cancer care, including during pre-diagnosis, treatment, and post-treatment. Differences such as greater recommendations for more aggressive treatments and difficulty in care transitions may lead to challenges being faced by younger women relative to their older counterparts. Tools such as checklists and guidelines may assist healthcare teams in meeting the needs of younger women. Future studies are warranted to assess the impact of such tools in helping improve patient education, advocacy, and support programs for this population.
Citation Format: DeCoteau MJ, Mercado MG, Ginsberg S, Dhir V, Brezden-Masley C. Breast cancer in young women in Canada: A needs assessment [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-17-03.