Late effects in a high-risk population of breast cancer survivors

Support Care Cancer. 2022 Feb;30(2):1749-1757. doi: 10.1007/s00520-021-06597-9. Epub 2021 Sep 29.

Abstract

Purpose: To better understand the impact of cancer and treatment on outcomes and guide program development, we evaluated breast cancer survivors at risk for long-term medical and psychosocial issues who participated in survivorship care visits (SVs) at Johns Hopkins Hospital.

Methods: We conducted a prospective survey study of women with stage I-III breast cancer who participated in SVs from 2010-2016. The same 56-item questionnaire administered at SV and follow-up included an assessment of symptoms, social factors, demographics, anxiety, depression, and comorbidities. We added the Godin Exercise questionnaire to the follow-up.

Results: In 2018, 74 participants were identified as disease-free and mailed a follow-up survey; 52 (70.3%) completed the survey. At a median follow-up time of 3.1 years after diagnosis, participants were less likely to be employed (54% vs. 67%) than at the SV. About two-thirds were sedentary, and this was associated with high body mass index (p = 0.02). Sufficiently active participants (≥ 150 min per week of moderate-intensity activity) were less likely to report pain (p = 0.02) or fatigue (p = 0.001). Although 19% had moderate/severe anxiety or depression at follow-up, participants who reported employment satisfaction were less likely to be depressed (p = 0.02).

Conclusions: Awareness of issues faced by survivors is critical for enhancing care and developing models to identify patients who might benefit most from targeted long-term interventions.

Implications for cancer survivors: Interventions to address physical activity, persistent symptoms, and mental health are critical for breast cancer survivors.

Keywords: Breast cancer; Mental health; Obesity; Patient-reported outcomes; Physical activity.

MeSH terms

  • Breast Neoplasms* / epidemiology
  • Breast Neoplasms* / therapy
  • Cancer Survivors*
  • Female
  • Humans
  • Prospective Studies
  • Quality of Life
  • Survivors