Psychological issues are increasingly being acknowledged by clinicians as primary concerns for breast cancer survivors after treatment. It is important to address psychosocial aspects not only to maintain quality of life for the patient, but also because these factors may reduce health screening practices that are critical for survivors.
Researchers assessed the psychosocial changes that occur over time in breast cancer patients after treatment. Women (N = 413) with unilateral stage I (49%), stage II (33%), or stage III (14%) disease were enrolled in a prospective study in Toronto, Canada, from 2014 to 2017. The patients underwent various types of surgery (48% unilateral lumpectomy, 36% unilateral mastectomy, 16% bilateral mastectomy) and tumors displayed diverse receptor profiles (68% HR-negative/HER2-negative, 14% HR-positive/HER2-positive, 8% HR-negative/HER2-positive, 10% HR-negative/HER2-negative). To assess changes in breast satisfaction, overall psychosocial and physical health, and sexual well-being, each patient completed psychosocial questionnaires before surgery (baseline) and 6 and 12 months post-surgery.
Surgery type, stage of disease, receptor profile, and therapy type intersect to influence a variety of psychosocial outcomes in patients with breast cancer. While there was no difference between unilateral and bilateral mastectomy, women who had unilateral mastectomy had the highest scores for breast satisfaction (P <.01), sexual (P <.01), and psychosocial health (P <.01). Conversely, being younger, receiving endocrine therapy, radiotherapy, and having triple-negative disease were associated with worse psychosocial outcomes. Surgical procedure was the most significant predictor of all outcomes assessed (breast satisfaction: P <.01; psychosocial: P <.01; physical: P <.01; sexual: P <.01). Type of treatment, HER2 positivity, and ethnicity were also reliable predictors of psychological factors. At 12 months, marital status predicted sexual health, while higher education and income levels were indicative of less distress.
The researchers conclude psychosocial function after breast cancer treatment is dependent on multiple factors. Identifying the specific contributors will promote better access to the necessary support these patients require.
Source: Lim DW, Retrouvey H, Kerrebijn I, et al. Impact of patient, tumour and treatment factors on psychosocial outcomes in invasive breast cancer. American Society of Clinical Oncology Virtual Meeting; June 4-8, 2021. Abstract 568.