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Who Are We Missing: Does Engagement in Patient-Reported Outcome Measures for Breast Cancer Vary by Age, Race, or Disease Stage?

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Patient-reported outcome measures (PROM) are used to assess value-based care. Little is known as to whether PROM response in breast cancer reflects the diverse patient population. The BREAST-Q, a validated measure of satisfaction and quality of life, and Recovery Tracker, a postoperative assessment tool, are PROM routinely delivered to all patients undergoing breast surgery at our institution. Here we determine whether response to PROM differs by age, race, language, or disease stage.

Methods

All patients who had a breast operation between January 2020 and July 2021 were requested to complete the BREAST-Q and Recovery Tracker. Non-responders did not complete the PROM at any timepoint; responders completed 1 or more. Primary outcomes included rates of non-response versus response overall.

Results

Of 6374 patients identified, 5653 (88.7%) responded to either PROM [4366/4751 (91.9%) BREAST-Q; 2746/3384 (81.1%) Recovery Tracker]. On univariate analysis, non-responders were older (60 years versus 55 years, p < 0.001) and more often non-English speaking (p < 0.001), Hispanic ethnicity (p = 0.031), and Black race (p < 0.001), versus responders. On multivariate analysis, non-responders were significantly more often Black race and non-English speaking (p < 0.001). Non-English speakers were significantly less responsive among all ethnicities and races except Black race. Although breast cancer stage did not reach significance for response, patients with malignant disease and those receiving neoadjuvant chemotherapy responded more often.

Conclusions

Our findings demonstrate high patient engagement using 2 different PROM following breast surgery, but suggest that PROM results may not reflect the experience of the entire breast cancer population. Care process changes based solely on PROM should consider these findings to ensure that the views of the entire spectrum of patients with breast cancer are represented.

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Acknowledgement

This study was presented as an oral poster at the Society of Surgical Oncology (SSO) 2022 International Conference on Surgical Cancer Care, Dallas, TX, March 9–12, 2022.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Marissa K. Srour MD, Audree B. Tadros MD, Tracy-Ann Moo MD & Monica Morrow MD

  2. Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Varadan Sevilimedu MBSS, DrPH

  3. Plastic and Reconstructive Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jonas A. Nelson MD, MPH

  4. Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jennifer R. Cracchiolo MD

  5. Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Taylor M. McCready MPH

  6. Department of Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Nicholas Silva BS

Authors
  1. Marissa K. Srour MD
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  2. Audree B. Tadros MD
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  3. Varadan Sevilimedu MBSS, DrPH
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  4. Jonas A. Nelson MD, MPH
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  5. Jennifer R. Cracchiolo MD
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  6. Taylor M. McCready MPH
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  7. Nicholas Silva BS
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  8. Tracy-Ann Moo MD
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  9. Monica Morrow MD
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Corresponding author

Correspondence to Monica Morrow MD.

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DISCLOSURES

The preparation of this study was supported in part by NIH/NCI Cancer Center Support Grant No. P30 CA008748 to Memorial Sloan Kettering Cancer Center. Dr. Monica Morrow has received honoraria from Exact Sciences and Roche. All other authors have no conflict of interest disclosures to report.

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Srour, M.K., Tadros, A.B., Sevilimedu, V. et al. Who Are We Missing: Does Engagement in Patient-Reported Outcome Measures for Breast Cancer Vary by Age, Race, or Disease Stage?. Ann Surg Oncol 29, 7964–7973 (2022). https://doi.org/10.1245/s10434-022-12477-1

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  • DOI: https://doi.org/10.1245/s10434-022-12477-1

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