Abstract PO4-17-01: Patient Perception and Decision-Making in HER2+ Early Breast Cancer Management: Insights from the ASKHER2 European Survey
Authors: Lambertini Matteo , Jackisch Christian , Trédan Olivier , Vidal Maria , Fontes-Sousa Mário , Valachis Antonios , D’Antona Rosanna , Ruz Marcelo , Krone Eugenia , Brice Miriam , Berjonneau Erwan , Matos Soraia , Dialla Olivia , Guéroult-Accolas Laure 
Published: May 2024

Abstract
Background
Breast cancer remains the most prevalent cancer in women globally, with Human Epidermal Growth Factor Receptor 2 positivity (HER2+) observed in 15-30% of initial breast cancer cases. Adjuvant treatment for HER2+ early breast cancer has notably reduced mortality and recurrence rates. However, the heterogeneity of the disease and in conveying risk information by healthcare providers (HCPs) leaves many women uncertain about their individual risk of recurrence and potential treatment (tx) options. Evidence shows that fear of recurrence, uncertainty about prognosis, and inadequate risk/benefit information can affect patients' decisions during their tx phase. Therefore, it is important to better understand the perceptions, attitudes, and behaviors regarding the risk of recurrence in women with HER2+ early breast cancer.
Methods
A protocol-driven, direct-to-patient online survey (30 questions total) was administered in France, Germany, Italy, Portugal, Spain, and Sweden via patient advocacy groups and panels. Women aged 18 years and above with either early-stage (eBC) (stages I-III) or metastatic (mBC) (stage IV) as the result of recurrence from an initial diagnosis of locally advanced HER2+ breast cancer were eligible to participate. The implementation of soft quotas ensured a representative sample size. This abstract presents the results of the survey.
Results
A total of 622 participants completed the survey between July 2022 and February 2023. Majority of participants (70%) were between 40 and 65 years of age. Almost 85% had eBC (N=527), 62% had been diagnosed with HER2+ eBC for ≥ 2 years, and 68% were undergoing breast cancer tx at the time of the survey.
The main worries and concerns that were reported by participants when asked about their tx plan were risk of recurrence (27%), fear of dying (22%) and risk of tx failure (14%). Among eBC participants, 40% perceived their personal risk of recurrence to be moderate, 18% perceived it to be high, while 21% did not know their personal risk. Most eBC participants (72%) preferred short and simple explanations from the medical team about the risk of cancer recurrence, while 4% preferred not to receive this information. Overall, 30% of participants said they had fully discussed the risk of recurrence with their doctor, while 20% had no discussion. Almost all participants (97%) wanted to be involved in their tx decision, 49% completely and 48% partially. To reduce this risk of recurrence, participants with eBC were willing to change their diet habits (77%), exercise more frequently (74%), take additional tx (65%) or undergo surgery (60%). Most participants (69%) were willing to take additional tx even if it would reduce their risk of recurrence by less than 50%. Participants were most willing to tolerate fatigue (53%), followed by hot flashes (51%) and joint pain (44%), as the most acceptable side effects if they had to take additional treatments with the potential benefit of reducing risk of recurrence.
Conclusion
The multinational large direct-to-patient ASKHER2 survey reflects participants’ experience and highlights concerns of patients with HER2+ breast cancer, notably on their recurrence risk. To mitigate this risk, patients exhibited a willingness to modify lifestyle habits and consider additional tx. A fraction of participants considered they had thoroughly discussed these risks with their HCPs, while the vast majority desired active involvement in their treatment decisions. These results underscore the ongoing need for HCPs to discuss the risk of recurrence in a clear way, addressing the full potential of treatment options in eBC and mBC, to enable patients to participate in this patient-centered approach of the decision-making process.
Citation Format: Matteo Lambertini, Christian Jackisch, Olivier Trédan, Maria Vidal, Mário Fontes-Sousa, Antonios Valachis, Rosanna D’Antona, Marcelo Ruz, Eugenia Krone, Miriam Brice, Erwan Berjonneau, Soraia Matos, Olivia Dialla, Laure Guéroult-Accolas. Patient Perception and Decision-Making in HER2+ Early Breast Cancer Management: Insights from the ASKHER2 European Survey [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-17-01.