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Author Notes:

Correspondence To: Christopher R. Friese, PhD, RN, AOCN®, FAAN, University of Michigan School of Nursing, 400 North Ingalls, #4162, Ann Arbor, MI 48109-5482 (cfriese@umich.edu) Telephone: 734-647-4308; Fax: 734-647-2416

See publication for full list of author contributions.

The ideas and opinions expressed herein are those of the authors.

The State of California, Department of Public Health, the NCI, and the CDC and their Contractors and Subcontractors had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

We acknowledge our project staff (Mackenzie Crawford and Kiyana Perrino from the Georgia Cancer Registry; Jennifer Zelaya, Pamela Lee, Maria Gaeta, Virginia Parker, and Renee Bickerstaff-Magee from USC; Rebecca Morrison, Rachel Tocco, Alexandra Jeanpierre, Stefanie Goodell, Rose Juhasz, Paul Abrahamse, Kent Griffith, and Irina Bondarenko from the University of Michigan).

We acknowledge with gratitude our survey respondents.

Subjects:

Research Funding:

This work was supported by the National Cancer Institute (P01CA163233 to S.J.K.).

Cancer incidence data collection was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP003862-04/DP003862; the NCI’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California (USC), and contract HHSN261201000034C awarded to the Public Health Institute.

Cancer incidence data collection in Georgia was supported by contract HHSN261201300015I, Task Order HHSN26100006 from the NCI and cooperative agreement 5NU58DP003875-04-00 from the CDC.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • breast cancer
  • patient report
  • treatment-associated toxicities
  • treatment experience
  • ONCOLOGY PATIENTS
  • DOSE-INTENSITY
  • CHEMOTHERAPY
  • OUTCOMES
  • TRIAL
  • CARE
  • RELIABILITY
  • PREDICTORS
  • NATIONWIDE
  • SYMPTOMS

Treatment-Associated Toxicities Reported by Patients With Early-Stage Invasive Breast Cancer

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Journal Title:

Cancer

Volume:

Volume 123, Number 11

Publisher:

, Pages 1925-1934

Type of Work:

Article | Post-print: After Peer Review

Abstract:

BACKGROUND: Patient-reported toxicities help to appraise the breast cancer treatment experience. Yet extant data come from clinical trials and health care claims, which may be biased. Using patient surveys, the authors 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. The authors assessed the frequency and severity of toxicities; correlated toxicity severity with unscheduled health care use (clinic visits, emergency department visits/hospitalizations) and physical health; and examined patient, tumor, and treatment factors associated with reporting increased toxicity severity. RESULTS: The overall survey response rate was 71%. From the analyzed cohort of 1945 women, 866 (45%) reported at least 1 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 receipt of chemotherapy (odds ratio [OR], 2.2; 95% confidence interval [95% CI], 2.0-2.5), receipt of both chemotherapy and radiotherapy (OR, 1.3; 95% CI, 1.0-1.7), and Latina ethnicity (OR vs whites: 1.3; 95% CI, 1.1-1.5). A nonsignificant increase in at least 1 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 observed by treatment modality may inform decision making. Cancer 2017;123:1925–1934.

Copyright information:

© 2017 American Cancer Society

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