Abstract P6-08-08: Adjuvant breast cancer therapy: Correlation of treatment data with patient reported outcomes in a German breast cancer centre
Authors: S Feiten, J Dünnebacke, J Heymanns, H Köppler, J Thomalla, C van Roye, D Wey, R Weide
Journal: Cancer Research (2013)

Abstract Objectives: Clinical diagnosis and treatment data lack a subjective perspective of the affected patients. Patient reported outcomes on the other hand often provide only basic information of the medical background. In this analysis we matched treatment data from clinical files and subjective experiences of breast cancer patients. Methods: Identification of breast cancer patients who had their primary surgery between 2006 and 2010 at a breast cancer centre followed by systemic adjuvant treatment. Relevant medical data were transferred from clinical files into a database and patients were asked to fill in a standardized paper pencil interview. Statistical analyses were conducted using SPSS 19. Results: 1044 unselected female patients who suffered from invasive breast cancer were contacted, 740 responded (return rate 70.9%) and 734 questionnaires could be analyzed. Non-responders showed no systematic differences in diagnosis or treatment. Median age at the time of the interview was 65 (30-91) for responders and 66 (33-96) for non-responders respectively (p = .412). Further analyses were conducted for the 734 responders only. Distribution according to UICC criteria at initial diagnosis was as follows: stage I 46%, stage II 42%, stage III 12%. 78% received breast-preserving surgery, 22% mastectomy. 3% received neo-adjuvant chemotherapy, 85% radiotherapy and 85% anti-hormonal therapy. 49% received adjuvant chemotherapy with taxane containing regimens in 60%. 91% were “satisfied” or “very satisfied” with the surgical result, in which patients with breast-preserving surgery were more satisfied than patients after mastectomy. 66% indicated a complete freedom of pain, 65% reported no limitations of arm or shoulder function. In both cases the results improved with increasing age. In frequency of antihormonal therapy a correspondence of 91% between data from medical records and subjectively reported treatment could be observed. Psychological distress, cognitive limitations and physical consequences were rated on a scale from 1 - “not at all” to 4 - “very much”. The highest average values were found for the items sleep disturbances (2.3) and exhaustion (2.3), the lowest for depression (1.7). Patients up to 60 years suffered more from the psychological consequences than older patients. 44% were in employment before the disease, 66% of them could return to their workplace. The return to work was as easier the younger the patients were. For 75% their partnership did not change, 12% experienced deterioration, 12% improvement. No effect of surgery or systemic treatment could be found here. Before the illness 9% consulted a psychiatrist / psychotherapist, after the illness 19%. Before the diagnosis of breast cancer 14% received antipsychotic drugs, after the disease 26%. In both cases is the increase in frequency stronger for younger patients and for patients who had received chemotherapy. Multivariate analyses will be presented. Conclusions: Adjuvant breast cancer therapy leads to long lasting impairment of physical, psychological, social and job-related functioning in a significant number of patients. Depending on age, surgery and systemic treatment patients are affected differently. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-08-08.