Early-stage breast cancer patients reporting difficulty sleeping, mood issues, or pain are more likely to refuse adjuvant hormone therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12065-e12065
Author(s):  
Christian A. Thomas
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Stage I ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy

e12065 Background: Adjuvant hormone therapy is a crucial part of the treatment for patients with early stage breast cancer and an important quality measure for programs such as QOPI and the oncology care model (OCM). However, it is not known which factors influence some patients with early stage breast cancer to decline adjuvant hormone therapy. We hypothesized that specific self-reported symptoms might impact a patient’s decision to accept or decline adjuvant hormone therapy. Methods: Patients with stage 0 or I breast cancer were identified by chart review from 2011-2016 and de-identified. On the day patients received a recommendation for adjuvant treatment the following patient reported outcome measures (PROs) were analyzed: difficulty sleeping (DS), fatigue (F), mood (M such as anxiety and depression), and pain (P) on a 0-4 symptom scale based on CTCAE v. 4. PROs were then linked with a patient’s decision to accept or decline adjuvant therapy. Results: A total of 287 patients with stage 0 (n = 80) or stage I (n = 207) breast cancer were identified. 38 stage O and 103 stage I patients had evaluable PROs on the same day a recommendation for adjuvant hormone therapy was made. Overall 18/38 (47.4%) of stage 0 patients and 90 of 103 (87.4%) of stage I patients accepted adjuvant treatment. Stage 0 patients declining adjuvant therapy reported any grade of PROs: DS (40%, n = 8), F (35%, n = 7), M (35%, n = 7), P (20%, n = 4). Stage 0 patients accepting treatment reported: DS (22%, n = 4), F (44%, n = 8), M (6%, n = 1), P (20%, n = 4). Stage I patients who declined treatment reported: DS (54%, n = 7), F (46%, n = 6), M (38%, n = 5), P (62%, n = 8). Stage I patients accepting treatment reported: DS (41%, n = 37), F (49%, n = 44), M (31%, n = 28), P (36%, n = 32). Conclusions: Early stage breast cancer patients declining adjuvant hormone therapy are more likely to self report symptoms such as difficulty sleeping, mood disturbances (anxiety, depression), and pain than those accepting treatment.

Quality of life and preferences for treatment following systemic adjuvant therapy for early-stage breast cancer.

1998 ◽  
Vol 16 (4) ◽  
pp. 1380-1387 ◽  
Author(s):  
C Lindley ◽  
S Vasa ◽  
W T Sawyer ◽  
E P Winer
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Adjuvant Therapy ◽  
Sexual Function ◽  
Cancer Patients ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Systemic Adjuvant Therapy

PURPOSE To evaluate the quality of life (QOL) of breast cancer patients who survived 2 to 5 years following initiation of adjuvant cytotoxic and/or hormonal therapy and to characterize relationships between QOL and patient physical symptoms, sexual function, and preferences regarding adjuvant treatment. PATIENTS AND METHODS Eighty-six patients who had completed systemic adjuvant therapy for early-stage breast cancer between 1988 and 1991 were surveyed by written questionnaire and telephone interview. Sociodemographic information was obtained for each patient, and patients were asked to complete the Functional Living Index-Cancer (FLIC), the Symptom Distress Scale (SDS), the Medical Outcomes Study (MOS) Short Form 36 (SF-36), a series of questions regarding sexual function, and a survey about preferences for adjuvant therapy in relation to possible benefit. RESULTS The mean FLIC score among all patients was 138.3 (+/- 12.2), which suggests a high level of QOL. The reported frequency of moderate to severe symptoms was generally low (ie, < 15%), with fatigue (31.4%), insomnia (23.3%), and local numbness at the site of surgery (22.1%) occurring with greatest frequency. Patients reported a wide range of sexual difficulties. Preference assessment showed that more than 65% of patients were willing to undergo 6 months of chemotherapy for a 5% increase in likelihood of cancer cure. CONCLUSION Self-rated QOL in breast cancer patients 2 to 5 years following adjuvant therapy was generally favorable. Less than one third of patients reported moderate to severe symptoms. Selected aspects of sexual function appeared to be compromised. The majority of patients indicated a willingness to accept 6 months of chemotherapy for small to modest potential benefit.

Adjuvant hormone therapy use in early-stage breast cancer patients insured by the New York State Medicaid program.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 6031-6031
Author(s):  
R. L. Yung ◽  
M. J. Hassett ◽  
K. Chen ◽  
F. C. Gesten ◽  
P. R. Roohan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New York ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Early Stage ◽  
New York State ◽  
Breast Cancer Patients ◽  
Medicaid Program ◽  
Adjuvant Hormone Therapy ◽  
York State

Association between immunity and prognostic factors in early stage breast cancer patients before adjuvant treatment

2000 ◽  
Vol 59 (3) ◽  
pp. 279-287 ◽  
Author(s):  
Marzio E.E. Sabbioni ◽  
Hans Peter Siegrist ◽  
Marisa Bacchi ◽  
Jürg Bernhard ◽  
Monica Castiglione ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients

Physical health and depression as predictors of fatigue in women with breast cancer undergoing chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8591-8591
Author(s):  
K. A. Shimabukuro ◽  
K. L. Clark ◽  
W. A. Bardwell ◽  
J. E. Mortimer
Keyword(s):  
Breast Cancer ◽  
Physical Health ◽  
Cancer Patients ◽  
Early Stage ◽  
Bodily Pain ◽  
Stage I ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
The Relationship ◽  
Over Time

8591 Background: Fatigue is common in breast cancer patients undergoing systemic chemotherapy and is also linked with depression. We evaluated the importance of physical health and depression in the fatigue reported by women with early-stage breast cancer undergoing adjuvant chemotherapy. Methodology: 75 women treated for Stage I-II breast cancer were assessed within 1mo after initiating chemotherapy (‘baseline‘) and at 2, 6 and 12mo. Scales included the Profile of Mood States (POMS) & SF36 quality of life (QOL) survey. The POMS contains fatigue and depression subscales (higher scores, worse mood symptoms). The SF36 is comprised of 4 physical and 4 mental health subscales (higher scores, better QOL). Results: 26 Stage I (46.4%) and 30 (53.6%) Stage II breast cancer patients provided baseline data (median age 53yrs; range 28–82 yrs). Fatigue decreased significantly from baseline to 12mo (p<0.01). Using Pearson correlations, worse physical health summary scores (r= −0.55, p<0.01) and higher depression scores (r=0.55, p<0.01) were independently linked with fatigue at baseline. In partial correlations controlling for depression, the relationship between physical health and fatigue remained significant (p<0.01), but was reduced in strength by 27%, although, the influence of depression on fatigue diminished over time. Similar patterns were observed for 3 of the SF36 physical health subscales. However, the relationship between fatigue and bodily pain was unchanged when controlling for depression (p<0.01), suggesting a strong independent relationship. In linear regression models, depression predicted fatigue at all time points and was the strongest predictor at baseline and 2mo; however physical health subscales assumed increasing importance in accounting for fatigue at 6 and 12mo. Conclusion: Depression is the strongest predictor of fatigue during chemotherapy, however, over time physical health variables become increasingly important at predicting fatigue in women with early stage breast cancer. Conducted at Washington University, supported by NIH CA72554–02 No significant financial relationships to disclose.

Treatment of depressive symptoms in breast cancer patients undergoing adjuvant therapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9631-9631
Author(s):  
Rudolph M. Navari
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Depressive Symptoms ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Newly Diagnosed ◽  
Breast Cancer Patients

9631 Background: Studies have shown a high prevalence of depression in patients with cancer. Women with breast cancer may have a high risk of depression particularly in a post-menopausal or estrogen deficient state and may develop a high level of depressive symptoms at the time of initial diagnosis. Newly diagnosed early stage breast cancer patients were screened for depressive symptoms prior to the initiation of adjuvant therapy. The oral antidepressant fluoxetine was studied to determine if its use affected depressive symptoms, completion of adjuvant treatment, quality of life, and survival. Methods: Patients with newly diagnosed early stage breast cancer were screened for depressive symptoms prior to the initiation of adjuvant therapy. Patients with depressive symptoms were randomized in a double blind fashion to daily oral fluoxetine (20 mg) or placebo. Patients were then followed for 6 months and evaluated for quality of life, completion of adjuvant treatment, and depressive symptoms. Patients with stage I disease at the time of initial diagnosis were subsequently assessed for disease recurrence and survival at five years. Results: Two hundred three of 357 screened patients with newly diagnosed early stage breast cancer were found to have depressive symptoms prior to the initiation of adjuvant therapy. One hundred ninety-three patients were randomized to fluoxetine or placebo. The use of fluoxetine for 6 months resulted in a significantly (p<0.01) higher number of patients with an improvement in quality of life, a higher completion of adjuvant treatment (chemotherapy, hormonal therapy, chemotherapy plus hormonal therapy) and a reduction in depressive symptoms compared to patients who received placebo. At five years, there was a significant (p<0.01) improvement in survival for patients with Stage I disease who received fluoxetine, possibly related to a higher completion of adjuvant treatment. Conclusions: An antidepressant should be considered for early stage breast cancer patients with depressive symptoms who are receiving adjuvant treatment.

Explanation model using pathological data for treatment outcome of patients with early-stage breast cancer with hormonal receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12006-e12006
Author(s):  
Naiyarat Prasongsook
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Hormonal Therapy ◽  
Tumor Size ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Ki 67

e12006 Background: The decision to initiate adjuvant chemotherapy for early-stage breast cancer patients with HR+ and HER2- is still unclear. Although the 21-gene Recurrence Score (RS) assay is a validated testing and becomes an emerging decision-making tool; it is still controversial guidance on adding adjuvant chemotherapy for patients with intermediate RS. This study aimed to develop the explanation model by using pathological information for prediction of the best outcome from adjuvant systemic treatment in these patients.Methods: Early-stage breast cancer patients with HR+, and HER2- who underwent complete resection registered within electronic medical record from 2003 to 2013 were included. Patient’s characteristics and pathological information were collected and analyzed. Univariate and multivariate analysis were conducted by using stepwise logistic regression. The explanation model was explored by using association between multivariate models and overall survival (OS).Results: 236 patients who underwent complete surgery treatment were included. 121 patients (51%) were treated with sequential adjuvant treatment, and 115 patients (48%) with anti-hormonal therapy alone. Clinicopathological parameters between two groups were demonstrated in Table1. Tumor size (≥2 – 5 cm), Estrogen receptor-negative/ Progesterone receptor-positive (ER-/PgR+), and Ki-67 expression were statistically significant multivariate independent prognostic factors for OS. When we adjusted for tumor size, HR status, and Ki-67 expression, the explanation model predicted 10-year OS was 99.2% for patients with sequential adjuvant treatment, whereas 89.5% for patients with adjuvant anti-hormonal alone (difference: 9.7%); p-value = 0.01.Conclusions: We found substantial discordance in 10-year OS benefit between early-breast cancer patients with HR+, HER2- with sequential adjuvant therapy and adjuvant hormonal therapy alone. Adjuvant chemotherapy should be considered in early-breast cancer patients with 2-3 cm in tumor size, ER-/PgR+, and Ki 67 expression.

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