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Treatment-Associated Toxicities Reported by Patients with Early-Stage Invasive Breast Cancer
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Jan 24 2017
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Source: Cancer. 123(11):1925-1934.
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Alternative Title:Cancer
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Personal Author:
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Description:Background
Patient-reported toxicities help to appraise the breast cancer treatment experience. Yet extant data come from clinical trials and healthcare claims, which may be biased. Using patient surveys, we sought to quantify the frequency, severity, and burden of treatment-associated toxicities.
Methods
Between 2013 and 2014, the iCanCare study surveyed a population-based sample of women residing in Los Angeles County and Georgia with early-stage, invasive breast cancer. We assessed the frequency and severity of toxicities, correlated toxicity severity with unscheduled healthcare use (clinic visits, emergency department visits/hospitalization) and physical health, and examined patient, tumor, and treatment factors associated with reporting increased toxicity severity.
Results
The overall survey response was 71%. From the analyzed cohort of 1,945 women, 866 (45%) reported at least one toxicity that was severe/very severe, 9% reported unscheduled clinic visits for toxicity management, and 5% visited an emergency department or hospital. Factors associated with reporting higher toxicity severity included: chemotherapy receipt (OR 2.2, 95% CI 2.0-2.5), both chemotherapy and radiation therapy receipt (OR 1.3, 95% CI 1.0-1.7), and Latina ethnicity (OR vs whites 1.3, 95% CI 1.1-1.5). A non-significant increase in at least one severe/very severe toxicity report was observed for bilateral mastectomy recipients (OR 1.2, 95% CI 1.0-1.4).
Conclusions
Women with early-stage invasive breast cancer report substantial treatment-associated toxicities and related burden. Clinicians should collect toxicity data routinely and offer early intervention. Toxicity differences by treatment modality may inform decision-making.
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Pubmed ID:28117882
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Pubmed Central ID:PMC5444953
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