Baseline characteristics of women initiating follow-up care in a newly developed breast cancer survivorship center.
Authors: Klemp JR , Smith AK , Ranallo L , Godbey D , Khan QJ , Fabian CJ 
Published: December 2010

Abstract
Abstract #1123
Background:&#x2028; BrCa survivors often have quality of life and medical management needs and wish to have active follow-up with an oncologist or oncology nurse practitioner (NP) specializing in BrCa in the initial 5-10 years post diagnosis- despite having completed treatment. We developed a self-contained, multi-disciplinary BrCa Survivorship Center within the University of Kansas Cancer Center which includes: 1) BrCa survivorship follow-up clinic; 2) cancer risk and genetic counseling; 3) fertility preservation; 4) cardio-oncology; 5) management of issues related to quality of life; and 6) energy balance. The mission was to provide follow-up and speciality services specific to the needs of BrCa survivors and evaluate this process.&#x2028; Methods:&#x2028; The Breast Cancer Survivorship Center opened in August 2007 at the University of Kansas Cancer Center. BrCa survivors &gt;3 years from diagnosis transferred to a breast oncologist or NP follow-up clinic from 3 breast oncology and 2 breast surgical oncology practices. At baseline, a comprehensive data set was completed from the patient health record and interview.&#x2028; Results:&#x2028; Demographics: 201 female BrCa survivors, median age = 58, 95% white, median time since diagnosis = 7 yrs.&#x2028; Tumor characteristics and Treatment: 89% of tumors were DCIS, T1 or T2; 74% were ER+, 37% node positive, 63% had lumpectomy, 23% received neo-adjuvant chemo, 56% received adjuvant chemo, 71% received adjuvant anti-hormonal therapy, 62% either currently on or had taken an aromatase inhibitor.&#x2028; Menopausal status: 49% pre-menopausal at diagnosis and only 5% pre-menopausal at entry into BCSC.&#x2028; Menopausal symptoms: 45% reported some degree of hot-flashes, 57% reported varying degrees of vaginal dryness, 46% were not sexually active.&#x2028; Energy Balance: average weight gain = 5.7 lbs, BMI at diagnosis = 25.7, BMI at initial Survivorship Center visit = 27.0, median self-reported minutes of exercise/week = 120. Cardiovascular Risk Factors: 21% were uncertain or no fasting lipid profile, 56% reported elevated cholesterol levels (&gt;200); 67% had &gt;3cardiac risk factors (defined by tx, personal factors, and family hx).&#x2028; Bone Density: 88% had a BMD within past 2 years; 47% of those reported osteopenia or osteoporosis and were recommended an oral bisphosphonate.&#x2028; Family History: 55% reported a family history of BrCa and 15% reported a family history of ovarian cancer; 33% (66) underwent BRCA1/2 testing, of those tested, 19% (7) were found to have a deleterious mutation&#x2028; Discussion:&#x2028; Our baseline data set identified a number of areas in women's health which were not being adequately addressed despite the fact that most women had been seen by both a PCP and an Oncologist within the past 12 months. These include: 1) energy balance, 2) cardiovascular health, 3) bone health, 4) menopausal symptoms (especially sexuality). BrCa Survivorship Centers have a unique opportunity to provide long-term oncologic follow-up, address unanswered clinical research questions, and positively impact several areas of women's health.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1123.