Abstract P1-12-02: Predictive variables of additional contacts with breast cancer counselors after sentinel lymph node negative breast conserving surgery in postmenopausal women
Authors: L Vandezande, M Reymen, B Raeymaekers, P Neven, M-R Christiaens
Journal: Cancer Research (2013)

Abstract Introduction: Since breast cancer diagnosis and treatment induces physical, personal, professional and social life disturbances, the University Hospitals Leuven implemented a system of track guidance. The goal is to increase continuity of care, psychosocial support and education. Track guidance combines a function of a breast cancer nurse, with a delimited package of social care. They navigate patients throughout their care program on several fixed moments, with exception of the target population. The latter receives only one fixed preoperative contact. Whenever needed, patients can ask for additional contacts. Objective: Exploration of predictive variables for additional contacts of postmenopausal women after limited breast surgery with the track guides. Methods: Data were retrieved from 98 patient files of postmenopausal women with breast conserving surgery and a negative sentinel lymph node treated in the Multidisciplinary Breast Center from January till October 2012. The dependent variable was defined as the presence of additional contacts. We screened multiple patient, disease and contact related factors as independent variables. Univariate analysis (UVA) was done by the Chi-square test and the Fisher exact test, followed by a multivariate logistic regression analysis (MVA). Results: 42.9% of the cohort had more than one contact with a track guide and 11.2% had a contact with a social worker. Of these 42.9% more than half of the patients had informational or psychosocial needs. In UVA, patients with more contacts had significant more contact with a psychologist before diagnosis (p = 0.008), chronic fatigue syndrome or fibromyalgia (p = 0.040), limited social network (p = 0.003), children living at home (p = 0.013), use of benzodiazepines (p = 0.013) and adjuvant chemotherapy (p &amp;lt; 0.001). The table shows which variables were important in the MVA model. Multivariate logistic regression analysisVariableRegression coefficient95% CIpContact with psychologist before diagnosis2.801.55-174.130.020Limited social network2.062.17-28.100.002Chemotherapy2.903.90-84.62&amp;lt;0.001 Conclusion: Even after limited surgery for breast cancer, women experience psychosocial and educational needs. Moreover, we identified 6 patient-related factors that determined the need for additional contacts with the track guides. Caution is warranted interpreting these results since almost one third of the additional contacts was initiated by the track guides themselves. Implications: Our results plea for at least two fixed contacts with the track guides for postmenopausal women even after limited surgery to provide psychosocial support and education. To gain in-depth insight in the experienced needs, qualitative research is needed. Subsequently prospective longitudinal research should be planned in order to develop and validate a screening tool that predicts patient's level of needs and allows more effective patient-centered care. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-12-02.